Provider Demographics
NPI:1841472974
Name:CHECKER TRANSPORTATION CORP.
Entity type:Organization
Organization Name:CHECKER TRANSPORTATION CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:FORTUNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-771-6200
Mailing Address - Street 1:47 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-2218
Mailing Address - Country:US
Mailing Address - Phone:516-771-6200
Mailing Address - Fax:516-771-6300
Practice Address - Street 1:47 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-2218
Practice Address - Country:US
Practice Address - Phone:516-771-6200
Practice Address - Fax:516-771-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02920501Medicaid