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General NPI Number Information
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NPI Number | 1013374404
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Entity Type | Organization
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Legal Business Name | NEW EXPERIENCE #1, INC.
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Dates
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Enumeration Date | 01/15/2016
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Last Update Date | 01/15/2016
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Provider Practice Location Address
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Address Line | 3833 29TH ST
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-2714
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Country | US
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Telephone | 718-729-0000
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Fax | 718-729-2024
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Provider Business Mailing Address
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Address Line | 3833 29TH ST
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-2714
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Country | US
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Telephone | 718-729-0000
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Fax | 718-729-2024
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | EDWARD LEON
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Credential |
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Telephone | 718-729-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number | B01467
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License Number State | NY
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