Healthcare Provider Details

I. General information

NPI: 1093566325
Provider Name (Legal Business Name): VITAL TRANSPORTATION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4124 38TH ST
LONG ISLAND CITY NY
11101-1709
US

IV. Provider business mailing address

4124 38TH ST
LONG ISLAND CITY NY
11101-1709
US

V. Phone/Fax

Practice location:
  • Phone: 718-472-2500
  • Fax:
Mailing address:
  • Phone: 718-472-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: GREG HAROUTUNIAN
Title or Position: PRESIDENT
Credential:
Phone: 212-472-2500