Healthcare Provider Details

I. General information

NPI: 1316583677
Provider Name (Legal Business Name): LYTA CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2019
Last Update Date: 11/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W OLNEY AVE
PHILADELPHIA PA
19120-2232
US

IV. Provider business mailing address

PO BOX 56581
PHILADELPHIA PA
19111-6581
US

V. Phone/Fax

Practice location:
  • Phone: 215-276-6400
  • Fax:
Mailing address:
  • Phone: 215-276-6400
  • 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: MR. TABEEL NOEL
Title or Position: COO
Credential:
Phone: 267-893-0998