Provider Demographics
NPI:1457372674
Name:INDEPENDENT MOBILITY SOLUTIONS INC.
Entity type:Organization
Organization Name:INDEPENDENT MOBILITY SOLUTIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:CORRAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-478-9219
Mailing Address - Street 1:440 GETTY AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2128
Mailing Address - Country:US
Mailing Address - Phone:973-478-9219
Mailing Address - Fax:973-955-2060
Practice Address - Street 1:440 GETTY AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2128
Practice Address - Country:US
Practice Address - Phone:973-478-9219
Practice Address - Fax:973-955-2060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0143472Medicaid
NJ5753820001Medicare NSC