Healthcare Provider Details

I. General information

NPI: 1932598620
Provider Name (Legal Business Name): LIMO SEVEN TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2015
Last Update Date: 02/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3514 14TH AVE
BROOKLYN NY
11218-3704
US

IV. Provider business mailing address

1571 63RD ST
BROOKLYN NY
11219-5419
US

V. Phone/Fax

Practice location:
  • Phone: 646-462-5191
  • Fax:
Mailing address:
  • Phone: 646-462-5191
  • Fax: 718-259-5466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberB02795
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License NumberB02795
License Number StateNY

VIII. Authorized Official

Name: FURKAT BOLTAEV
Title or Position: PRESIDENT
Credential:
Phone: 646-462-5191