Provider Demographics
NPI:1770771545
Name:ABA TRANSPORT CORP.
Entity type:Organization
Organization Name:ABA TRANSPORT CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VADIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KRIZHEVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-436-1400
Mailing Address - Street 1:8303 24TH AVE
Mailing Address - Street 2:2 FLOOR
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-1660
Mailing Address - Country:US
Mailing Address - Phone:718-505-3100
Mailing Address - Fax:718-424-8181
Practice Address - Street 1:8303 24TH AVE
Practice Address - Street 2:2 FLOOR
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11370-1660
Practice Address - Country:US
Practice Address - Phone:718-505-3100
Practice Address - Fax:718-424-8181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYDOT#30718343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02903675Medicaid