Healthcare Provider Details

I. General information

NPI: 1285009829
Provider Name (Legal Business Name): JIFF XPRESS LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2015
Last Update Date: 12/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

438 STUYVESANT AVE
LYNDHURST NJ
07071-2347
US

IV. Provider business mailing address

438 STUYVESANT AVE
LYNDHURST NJ
07071-2347
US

V. Phone/Fax

Practice location:
  • Phone: 201-580-9197
  • Fax:
Mailing address:
  • Phone: 201-580-9197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberA12242597401662
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberA12242597401662
License Number StateNJ

VIII. Authorized Official

Name: FELIX MANUEL ACEVEDO JR.
Title or Position: OWNER
Credential:
Phone: 201-580-9197