MEDICARE: VISMAR RADIO DISPATCH INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	344600000X	Taxi	B02760	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063892388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISMAR RADIO DISPATCH INC.

Provider Business Mailing Address
First Line	:	1040 FREEMAN ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10459
Country	:	US
Telephone Number	:	917-801-4397
Fax Number	:	917-801-4344

Provider Business Practice Location Address
First Line	:	1040-52 FREEMAN ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10459
Country	:	US
Telephone Number	:	917-801-4397
Fax Number	:	917-801-4344

Authorized Official
Title or Position	:	SECRETARY
Name	:	YEISSEL MARTINEZ
Credential	:
Telephone Number	:	917-801-4397

Provider Enumeration Date	:	06/02/2015
Last Update Date	:	06/02/2015

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