Provider Demographics
NPI:1548692825
Name:AMITY SHUTTLE INC
Entity type:Organization
Organization Name:AMITY SHUTTLE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KIEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:ANGUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-790-2600
Mailing Address - Street 1:30 CARROL ST
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-1852
Mailing Address - Country:US
Mailing Address - Phone:631-842-2000
Mailing Address - Fax:631-842-2500
Practice Address - Street 1:116 BROADWAY
Practice Address - Street 2:SUITE-7
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2797
Practice Address - Country:US
Practice Address - Phone:631-842-2000
Practice Address - Fax:631-842-2500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343900000X343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01928981Medicaid