Healthcare Provider Details

I. General information

NPI: 1508601022
Provider Name (Legal Business Name): CENTURYLINK TRANSPORTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2024
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CEDAR ST APT 212
FORT LEE NJ
07024-7033
US

IV. Provider business mailing address

629 W 173RD ST APT 3E
NEW YORK NY
10032-1421
US

V. Phone/Fax

Practice location:
  • Phone: 201-925-4836
  • Fax:
Mailing address:
  • Phone: 201-925-4836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: ROSSANA GUERRERO
Title or Position: PRESIDENT /OWNER
Credential:
Phone: 201-925-4836