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General NPI Number Information
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NPI Number | 1154871523
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Entity Type | Organization
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Legal Business Name | LJC SERVICES LLC
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Dates
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Enumeration Date | 10/10/2016
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Last Update Date | 10/10/2016
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Provider Practice Location Address
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Address Line | 10 WATER ST
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City | OSSINING
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State | NY
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Zip | 10562-4604
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Country | US
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Telephone | 914-923-8294
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Fax | 914-762-8726
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Provider Business Mailing Address
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Address Line | 10 WATER ST
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City | OSSINING
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State | NY
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Zip | 10562-4604
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Country | US
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Telephone | 914-923-8294
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Fax | 914-762-8726
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. JEROME JOHNSON
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Credential |
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Telephone | 914-447-8350
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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 | 0011014
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License Number State | NY
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