Healthcare Provider Details

I. General information

NPI: 1194138198
Provider Name (Legal Business Name): MAVROS TRANSPORTATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2014
Last Update Date: 06/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4918 FOSTER AVE
BROOKLYN NY
11203
US

IV. Provider business mailing address

4918 FOSTER AVE
BROOKLYN NY
11203
US

V. Phone/Fax

Practice location:
  • Phone: 718-629-1038
  • Fax: 718-629-1429
Mailing address:
  • Phone: 718-629-1038
  • Fax: 718-629-1429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberB02769
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License NumberB02769
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberB02769
License Number StateNY

VIII. Authorized Official

Name: ROXANNE HEWLING
Title or Position: PRESIDENT
Credential:
Phone: 347-935-0321