Provider Demographics
NPI:1962608513
Name:MAJESTIC TRANSPORTATION,INC
Entity type:Organization
Organization Name:MAJESTIC TRANSPORTATION,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANEGER
Authorized Official - Prefix:MR
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:GEKHTBARG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-616-1300
Mailing Address - Street 1:3173 CONEY ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6443
Mailing Address - Country:US
Mailing Address - Phone:718-616-1300
Mailing Address - Fax:718-616-1306
Practice Address - Street 1:3173 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6443
Practice Address - Country:US
Practice Address - Phone:718-616-1300
Practice Address - Fax:718-616-1306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02380954Medicaid