Provider Demographics
NPI:1841664331
Name:GALLANT LUXURY SERVICE
Entity type:Organization
Organization Name:GALLANT LUXURY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SOCRATES
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-465-1844
Mailing Address - Street 1:5030 BROADWAY
Mailing Address - Street 2:SUITE 677
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-1609
Mailing Address - Country:US
Mailing Address - Phone:212-304-0707
Mailing Address - Fax:
Practice Address - Street 1:5030 BROADWAY
Practice Address - Street 2:SUITE 677
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-1609
Practice Address - Country:US
Practice Address - Phone:212-304-0707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-20
Last Update Date:2015-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYB02901344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi