Provider Demographics
NPI:1902971195
Name:MEDSTAR AMBULETTE INC.,
Entity Type:Organization
Organization Name:MEDSTAR AMBULETTE INC.,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ORLOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-788-4200
Mailing Address - Street 1:718 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-1113
Mailing Address - Country:US
Mailing Address - Phone:718-788-4200
Mailing Address - Fax:718-788-2022
Practice Address - Street 1:718 3RD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-1113
Practice Address - Country:US
Practice Address - Phone:718-788-4200
Practice Address - Fax:718-788-2022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)