Provider Demographics
NPI:1356009450
Name:LEGACY TRANSIT INC
Entity type:Organization
Organization Name:LEGACY TRANSIT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MALAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:FADIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-244-4440
Mailing Address - Street 1:924 BERGEN AVE STE 171
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3018
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:924 BERGEN AVE STE 171
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3018
Practice Address - Country:US
Practice Address - Phone:201-244-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)