Healthcare Provider Details

I. General information

NPI: 1427819218
Provider Name (Legal Business Name): BLACK RIDE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2024
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3715 73RD ST FL 2
JACKSON HEIGHTS NY
11372-6263
US

IV. Provider business mailing address

7110 35TH AVE
JACKSON HEIGHTS NY
11372-3910
US

V. Phone/Fax

Practice location:
  • Phone: 917-400-3111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State

VIII. Authorized Official

Name: MOHD SALAHUDDIN
Title or Position: PRESIDENT
Credential:
Phone: 917-400-3110