MEDICARE: LSLAT 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	343900000X	Non-emergency Medical Transport (VAN)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891908125
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LSLAT INC

Provider Business Mailing Address
First Line	:	7410 20TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-5703
Country	:	US
Telephone Number	:	718-236-7070
Fax Number	:	718-236-4544

Provider Business Practice Location Address
First Line	:	7410 20TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-5703
Country	:	US
Telephone Number	:	718-236-7070
Fax Number	:	718-236-4544

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. SAMUEL NUDEL
Credential	:
Telephone Number	:	718-236-7070

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	08/22/2020

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