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General NPI Number Information
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NPI Number | 1528340247
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Entity Type | Organization
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Legal Business Name | CROSSTOWN LIVERY LLC
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Dates
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Enumeration Date | 09/20/2011
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Last Update Date | 09/20/2011
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Provider Practice Location Address
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Address Line | 3747A VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-6780
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Country | US
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Telephone | 718-698-4493
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Fax |
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Provider Business Mailing Address
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Address Line | 3747A VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-6780
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Country | US
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Telephone | 718-698-4493
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MARIO CROSS
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Credential |
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Telephone | 718-698-4493
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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 | B00023
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License Number State | NY
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