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General NPI Number Information
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NPI Number | 1922594969
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Entity Type | Organization
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Legal Business Name | LOS TIOS TAXI SERVICE CORP
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Dates
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Enumeration Date | 07/02/2018
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Last Update Date | 07/02/2018
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Provider Practice Location Address
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Address Line | 212 TROUVILLE RD
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City | COPIAGUE
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State | NY
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Zip | 11726-3002
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Country | US
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Telephone | 631-918-3533
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Fax |
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Provider Business Mailing Address
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Address Line | 212 TROUVILLE RD
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City | COPIAGUE
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State | NY
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Zip | 11726-3002
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Country | US
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Telephone | 631-918-3533
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HUMBERTO TAVAREZ
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Credential |
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Telephone | 631-918-3533
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number | 4975098
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License Number State | NY
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