Provider Demographics
NPI:1295367647
Name:ALLMEDICAL AMBULETTE INC.
Entity type:Organization
Organization Name:ALLMEDICAL AMBULETTE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SHIA
Authorized Official - Middle Name:W
Authorized Official - Last Name:GREENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-407-4151
Mailing Address - Street 1:165 FRANKLIN AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-2760
Mailing Address - Country:US
Mailing Address - Phone:718-407-4151
Mailing Address - Fax:917-591-8404
Practice Address - Street 1:777 KENT AVE STE 239A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-1588
Practice Address - Country:US
Practice Address - Phone:718-407-4151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02754314Medicaid