Provider Demographics
NPI:1992307664
Name:ADAMES, RAYLOR
Entity type:Individual
Prefix:
First Name:RAYLOR
Middle Name:
Last Name:ADAMES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07104-1331
Mailing Address - Country:US
Mailing Address - Phone:973-970-3331
Mailing Address - Fax:973-221-8832
Practice Address - Street 1:417 LAKE ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07104-1331
Practice Address - Country:US
Practice Address - Phone:973-970-3331
Practice Address - Fax:973-221-8832
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)