Healthcare Provider Details

I. General information

NPI: 1326975764
Provider Name (Legal Business Name): CLJ EXPRESS LIMO SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

936 SCHOOL DR
NORTH BALDWIN NY
11510-1126
US

IV. Provider business mailing address

936 SCHOOL DR
NORTH BALDWIN NY
11510-1126
US

V. Phone/Fax

Practice location:
  • Phone: 631-202-9396
  • Fax: 631-202-9396
Mailing address:
  • Phone: 631-202-9396
  • Fax: 631-202-9396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: SEWENA BL ADJAVEHOUEDE
Title or Position: PRESIDENT
Credential: ADJAVEHOUEDE
Phone: 631-202-9396