Provider Demographics
NPI:1962531533
Name:ALL ISLAND AMBULETTE INC
Entity type:Organization
Organization Name:ALL ISLAND AMBULETTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GENNADIY
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDURAKHMANOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-903-2086
Mailing Address - Street 1:1250 ST. LOUIS AVE
Mailing Address - Street 2:
Mailing Address - City:BAYSHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706
Mailing Address - Country:US
Mailing Address - Phone:631-666-7700
Mailing Address - Fax:631-666-7762
Practice Address - Street 1:1224 BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-3920
Practice Address - Country:US
Practice Address - Phone:631-666-7700
Practice Address - Fax:631-666-7762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02663629343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)