Healthcare Provider Details

I. General information

NPI: 1215804141
Provider Name (Legal Business Name): EZZY RIDE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 10/23/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

289 REYNOLDS TERRACE
ORANGE NJ
07050-3305
US

IV. Provider business mailing address

289 REYNOLDS TERRACE
ORANGE NJ
07050-3305
US

V. Phone/Fax

Practice location:
  • Phone: 862-588-0844
  • Fax: 973-675-0726
Mailing address:
  • Phone: 862-588-0844
  • Fax: 973-675-0726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ROSELINE ASEMOTA
Title or Position: OWNER
Credential:
Phone: 862-588-0844