MEDICARE: DOLPHIN MEDICAL TRANSPORTATION 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	343900000X	Non-emergency Medical Transport (VAN)

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	:	1285846519
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOLPHIN MEDICAL TRANSPORTATION INC

Provider Business Mailing Address
First Line	:	104 AVENUE O
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-6504
Country	:	US
Telephone Number	:	718-234-2207
Fax Number	:	718-234-7554

Provider Business Practice Location Address
First Line	:	104 AVENUE O
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-6504
Country	:	US
Telephone Number	:	718-234-2207
Fax Number	:	718-234-7554

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. OLEG DIKSHTEIN
Credential	:
Telephone Number	:	718-234-2207

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	08/22/2020

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