Provider Demographics
NPI:1952959629
Name:BROADWAY CAR SERVICE INC
Entity Type:Organization
Organization Name:BROADWAY CAR SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:FORTUNATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-299-3605
Mailing Address - Street 1:PO BOX 1036
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10551-1036
Mailing Address - Country:US
Mailing Address - Phone:914-299-3605
Mailing Address - Fax:
Practice Address - Street 1:435 S BROADWAY
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-2371
Practice Address - Country:US
Practice Address - Phone:914-299-3605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi