MEDICARE: ATLANTIS TRANSPORTATION SERVICES 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)		NY
2	344600000X	Taxi		NY

General Provider Information

NPI Number	:	1861926859
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTIS TRANSPORTATION SERVICES INC

Provider Business Mailing Address
First Line	:	2402 GERRITSEN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5904
Country	:	US
Telephone Number	:	212-991-8963
Fax Number	:	718-375-3563

Provider Business Practice Location Address
First Line	:	2402 GERRITSEN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5904
Country	:	US
Telephone Number	:	212-991-8963
Fax Number	:	718-375-3563

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. KAREN IZRAILOV
Credential	:
Telephone Number	:	212-991-8963

Provider Enumeration Date	:	04/17/2017
Last Update Date	:	07/21/2022

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