Healthcare Provider Details

I. General information

NPI: 1750602843
Provider Name (Legal Business Name): 24-7 AMBU-TRANS LIMITED LIABILITY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2010
Last Update Date: 06/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 PHELPS AVE
TENAFLY NJ
07670-2819
US

IV. Provider business mailing address

19 PHELPS AVE
TENAFLY NJ
07670-2819
US

V. Phone/Fax

Practice location:
  • Phone: 718-362-0564
  • Fax: 201-484-8485
Mailing address:
  • Phone: 718-362-0564
  • Fax: 201-484-8485

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: MR. NICHOLAS MINICUCCCI JR.
Title or Position: GENERAL PARTNER
Credential:
Phone: 718-362-0564