Provider Demographics
NPI:1730768037
Name:NORTSTAR TRANSPORTATION INC.
Entity type:Organization
Organization Name:NORTSTAR TRANSPORTATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:V
Authorized Official - Last Name:SEBASTIAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:315-404-8155
Mailing Address - Street 1:103 GAUSS RD
Mailing Address - Street 2:
Mailing Address - City:REMSEN
Mailing Address - State:NY
Mailing Address - Zip Code:13438-5823
Mailing Address - Country:US
Mailing Address - Phone:315-896-6700
Mailing Address - Fax:315-896-6701
Practice Address - Street 1:103 GAUSS RD
Practice Address - Street 2:
Practice Address - City:REMSEN
Practice Address - State:NY
Practice Address - Zip Code:13438-5823
Practice Address - Country:US
Practice Address - Phone:315-896-6700
Practice Address - Fax:315-896-6701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-05
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04672271Medicaid