Provider Demographics
NPI:1841410982
Name:M J TRANS CORP
Entity type:Organization
Organization Name:M J TRANS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:YURI
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVITAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-642-4407
Mailing Address - Street 1:1788 STILLWELL AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-1009
Mailing Address - Country:US
Mailing Address - Phone:718-333-0400
Mailing Address - Fax:718-333-9127
Practice Address - Street 1:1788 STILLWELL AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1009
Practice Address - Country:US
Practice Address - Phone:718-333-0400
Practice Address - Fax:718-333-9127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02214395Medicaid