Healthcare Provider Details

I. General information

NPI: 1235050121
Provider Name (Legal Business Name): EDGE MEDICAL TRANSPORTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 2ND ST STE 2026
ELIZABETH NJ
07206-1901
US

IV. Provider business mailing address

200 2ND ST STE 2026
ELIZABETH NJ
07206-1901
US

V. Phone/Fax

Practice location:
  • Phone: 347-524-7869
  • Fax:
Mailing address:
  • Phone: 347-524-7869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ERLINE MOISSET
Title or Position: OWNER
Credential:
Phone: 347-557-6593