Provider Demographics
NPI:1417571357
Name:FAMILY TRANSPORTATION
Entity type:Organization
Organization Name:FAMILY TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEFREITAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-877-2200
Mailing Address - Street 1:204 MOHAWK DR
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13211-1834
Mailing Address - Country:US
Mailing Address - Phone:315-877-2200
Mailing Address - Fax:
Practice Address - Street 1:204 MOHAWK DR
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13211-1834
Practice Address - Country:US
Practice Address - Phone:315-877-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-06
Last Update Date:2020-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi