Healthcare Provider Details

I. General information

NPI: 1386722890
Provider Name (Legal Business Name): VIN JAC TAXI CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26412 HILLSIDE AVE
FLORAL PARK NY
11004-1738
US

IV. Provider business mailing address

26412 HILLSIDE AVE
FLORAL PARK NY
11004-1738
US

V. Phone/Fax

Practice location:
  • Phone: 718-347-3222
  • Fax: 718-347-7552
Mailing address:
  • Phone: 718-347-3222
  • Fax: 718-347-7552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. LUCILLE GOLDFINE
Title or Position: PRESIDENT
Credential:
Phone: 718-347-3222