Healthcare Provider Details

I. General information

NPI: 1720903636
Provider Name (Legal Business Name): GENTLE MILE TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 UNIVERSITY PLZ STE 100
HACKENSACK NJ
07601-6210
US

IV. Provider business mailing address

2 UNIVERSITY PLZ STE 100
HACKENSACK NJ
07601-6210
US

V. Phone/Fax

Practice location:
  • Phone: 732-466-4004
  • Fax:
Mailing address:
  • Phone: 732-466-4004
  • 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: CLARENCE CICERON
Title or Position: CEO
Credential:
Phone: 929-319-6822