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General NPI Number Information
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NPI Number | 1427279363
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Entity Type | Organization
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Legal Business Name | BLACK SEA TRANSPORTATION, INC
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1754 HYLAN BLVD FL 2
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City | STATEN ISLAND
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State | NY
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Zip | 10305-1932
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Country | US
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Telephone | 718-605-1200
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Fax | 718-605-0206
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Provider Business Mailing Address
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Address Line | 27 MICHAEL CT
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City | STATEN ISLAND
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State | NY
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Zip | 10308-2020
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Country | US
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Telephone | 718-605-1200
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Fax | 718-605-0206
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Authorized Official
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Title or Position | VISE PRESIDENT
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Name | MR. MICHAEL MOGILEVSKIY
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Credential |
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Telephone | 718-605-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | B90579
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License Number State | NY
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