Provider Demographics
NPI:1992258636
Name:MEDI LIVERY SERVICES LLC
Entity type:Organization
Organization Name:MEDI LIVERY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:NESHEIWAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-616-5836
Mailing Address - Street 1:3 NEPTUNE RD STE N11
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-7109
Mailing Address - Country:US
Mailing Address - Phone:855-444-4548
Mailing Address - Fax:845-345-5056
Practice Address - Street 1:3 NEPTUNE RD STE N11
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-7109
Practice Address - Country:US
Practice Address - Phone:855-444-4548
Practice Address - Fax:845-345-5056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03766236Medicaid