Healthcare Provider Details

I. General information

NPI: 1225386709
Provider Name (Legal Business Name): MVP LEASING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2012
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 E 241ST ST
BRONX NY
10470-1301
US

IV. Provider business mailing address

711 E 241ST ST
BRONX NY
10470-1301
US

V. Phone/Fax

Practice location:
  • Phone: 914-490-5397
  • Fax: 718-324-2845
Mailing address:
  • Phone: 914-490-5397
  • Fax: 718-324-2845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License NumberB00597
License Number StateNY

VIII. Authorized Official

Name: MR. ANTHONY POLIZZI
Title or Position: PRESIDENT AND CEO
Credential: PRESIDENT
Phone: 914-490-5397