Healthcare Provider Details

I. General information

NPI: 1942147996
Provider Name (Legal Business Name): ELITE MEDICAL TRANSIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 JENNINGS AVE
WEST HEMPSTEAD NY
11552-3832
US

IV. Provider business mailing address

704 JENNINGS AVE
WEST HEMPSTEAD NY
11552-3832
US

V. Phone/Fax

Practice location:
  • Phone: 516-404-0128
  • Fax:
Mailing address:
  • Phone: 631-796-1888
  • Fax:

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: SERGINA JEAN
Title or Position: OWNER
Credential: FNP
Phone: 631-796-1888