MEDICARE: FRIELECH CAR & LIMO SERVICE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	344600000X	Taxi	B02675	NY

General Provider Information

NPI Number	:	1659751329
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIELECH CAR & LIMO SERVICE INC.

Provider Business Mailing Address
First Line	:	4101 15TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-1505
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4101 15TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-1505
Country	:	US
Telephone Number	:	917-982-8015
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	VADIM KULISHEVSKIY
Credential	:
Telephone Number	:	917-982-8015

Provider Enumeration Date	:	06/08/2015
Last Update Date	:	06/08/2015

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