Healthcare Provider Details
I. General information
NPI: 1154672087
Provider Name (Legal Business Name): NORTHSTAR VAN SERVICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2012
Last Update Date: 10/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
77 BEAUMONT CIR 2
YONKERS NY
10710-2040
US
IV. Provider business mailing address
77 BEAUMONT CIR 2
YONKERS NY
10710-2040
US
V. Phone/Fax
- Phone: 914-414-0144
- Fax:
- Phone: 914-414-0144
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 344600000X |
| Taxonomy | Taxi |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ZAHEER
UDDIN
BABAR
Title or Position: OWNER
Credential: PRESEDENT
Phone: 914-414-0144