Healthcare Provider Details

I. General information

NPI: 1538073879
Provider Name (Legal Business Name): MR. JAMEEL SIRMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: NIGHTSTAR LOGISTICS LLC

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MOHAWK DR APT 8C
STAR LAKE NY
13690-3128
US

IV. Provider business mailing address

10 MOHAWK DR APT 8C
STAR LAKE NY
13690-3128
US

V. Phone/Fax

Practice location:
  • Phone: 315-403-3660
  • Fax:
Mailing address:
  • Phone: 315-403-3660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: