Healthcare Provider Details

I. General information

NPI: 1487561197
Provider Name (Legal Business Name): OPEN DOOR MEDICAL RIDES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

479 15TH AVE UNIT 2
NEWARK NJ
07103-2003
US

IV. Provider business mailing address

479 15TH AVE UNIT 2
NEWARK NJ
07103-2003
US

V. Phone/Fax

Practice location:
  • Phone: 347-395-9878
  • Fax:
Mailing address:
  • Phone:
  • 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: AYESHAH ATSEGBUA
Title or Position: FOUNDER
Credential: RN
Phone: 347-395-9878