1538368998 NPI number — METROPOLITAN MED TRANSPORTATION INC.

Table of content: (NPI 1538368998)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538368998 NPI number — METROPOLITAN MED TRANSPORTATION INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
METROPOLITAN MED TRANSPORTATION INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NORTHEAST METRO AMBULANCES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538368998
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/22/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
514 N MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BARNEGAT
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08005-2143
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-296-0625
Provider Business Mailing Address Fax Number:
609-257-0959

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 COXS AVE
Provider Second Line Business Practice Location Address:
UNIT 10
Provider Business Practice Location Address City Name:
WEST CREEK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08092-3233
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-296-0625
Provider Business Practice Location Address Fax Number:
609-257-0959
Provider Enumeration Date:
07/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
REZVINE
Authorized Official First Name:
ILIYA
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE-PRESIDENT
Authorized Official Telephone Number:
609-296-0625

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X , with the licence number: N0313054 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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