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NPI Code Detail

MEDICARE: JUNIORS LUXURY INC

MEDICARE: JUNIORS LUXURY 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
1343900000XNon-emergency Medical Transport (VAN)

Other Identifiers

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

General Provider Information

NPI Number : 1427612605
Entity Type Code : Organization
Provider Name (Legal Business Name) : JUNIORS LUXURY INC
Provider Business Mailing Address
First Line : 6809 3RD AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-5828
Country : US
Telephone Number : 718-940-1919
Fax Number : 718-462-6867
Provider Business Practice Location Address
First Line : 1509 CORTELYOU RD
Second Line :
City : BROOKLYN
State : NY
Zip : 11226-5607
Country : US
Telephone Number : 718-859-1111
Fax Number : 718-462-6867
Authorized Official
Title or Position : PRESIDENT
Name : MR. RAUL IZQUIERDO JR.
Credential :
Telephone Number : 718-690-4306
Provider Enumeration Date : 04/23/2019
Last Update Date : 11/22/2022

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