Provider Demographics
NPI:1952711491
Name:FOUR SISTERS MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:FOUR SISTERS MEDICAL TRANSPORTATION
Other - Org Name:EMTRAK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PERLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORDONEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-279-9543
Mailing Address - Street 1:612 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-3004
Mailing Address - Country:US
Mailing Address - Phone:201-613-4413
Mailing Address - Fax:201-355-8567
Practice Address - Street 1:612 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071-3004
Practice Address - Country:US
Practice Address - Phone:201-613-4413
Practice Address - Fax:201-355-8567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-06
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ100639341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ349252Medicare PIN