Provider Demographics
NPI:1205092251
Name:MAJOR AMBULETTE CO
Entity type:Organization
Organization Name:MAJOR AMBULETTE CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-265-3333
Mailing Address - Street 1:2201 AVENUE X
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2540
Mailing Address - Country:US
Mailing Address - Phone:718-265-3333
Mailing Address - Fax:718-264-6040
Practice Address - Street 1:2201 AVENUE X
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2540
Practice Address - Country:US
Practice Address - Phone:718-265-3333
Practice Address - Fax:718-264-6040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYB90288343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01352712Medicaid