Provider Demographics
NPI:1912321936
Name:MASA AMBULETTE TRANSPORTERS, INC.
Entity Type:Organization
Organization Name:MASA AMBULETTE TRANSPORTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TZVI
Authorized Official - Middle Name:
Authorized Official - Last Name:WERTHEIMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-222-3011
Mailing Address - Street 1:2 MOUNTAIN RD UNIT 112
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-2073
Mailing Address - Country:US
Mailing Address - Phone:845-222-3011
Mailing Address - Fax:845-783-2187
Practice Address - Street 1:2 MOUNTAIN RD UNIT 112
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-2073
Practice Address - Country:US
Practice Address - Phone:845-222-3011
Practice Address - Fax:845-783-2187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY34025343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01956981Medicaid