Provider Demographics
NPI:1073355970
Name:MECHTOVICH, ZINOVIY (NON-EMERGENCY TRANSP)
Entity type:Individual
Prefix:
First Name:ZINOVIY
Middle Name:
Last Name:MECHTOVICH
Suffix:
Gender:M
Credentials:NON-EMERGENCY TRANSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 WINFIELD ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-3542
Mailing Address - Country:US
Mailing Address - Phone:917-531-7640
Mailing Address - Fax:
Practice Address - Street 1:122 WINFIELD ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3542
Practice Address - Country:US
Practice Address - Phone:917-531-7640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)