Provider Demographics
NPI:1073003406
Name:CELLULAR TELECOMMUNICATIONS SERVICES INC
Entity type:Organization
Organization Name:CELLULAR TELECOMMUNICATIONS SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MELIHOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-744-2572
Mailing Address - Street 1:400 CLIVE PL
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-3407
Mailing Address - Country:US
Mailing Address - Phone:347-744-2572
Mailing Address - Fax:
Practice Address - Street 1:6522 17TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-3653
Practice Address - Country:US
Practice Address - Phone:718-577-7886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========Medicaid