MEDICARE: ELISE 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)

General Provider Information

NPI Number	:	1518591833
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELISE TRANSPORTATION,INC

Provider Business Mailing Address
First Line	:	5124 AVENUE N
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-3843
Country	:	US
Telephone Number	:	516-451-8226
Fax Number	:	718-377-0098

Provider Business Practice Location Address
First Line	:	5124 AVENUE N
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-3843
Country	:	US
Telephone Number	:	516-451-8226
Fax Number	:	718-377-0098

Authorized Official
Title or Position	:	CEO
Name	:	MR. YVES JEAN
Credential	:
Telephone Number	:	516-451-8226

Provider Enumeration Date	:	02/25/2020
Last Update Date	:	02/25/2020

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