Organization
BRIGHTON 1 CAR @ LIMO SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BORIS POLYAKOV (PRESIDENT)
(718) 265-0707
Entity
Organization
Contact information
Practice address
3072 BRIGHTON 1ST ST, BROOKLYN, NY 11235-8009
(718) 265-0707
Mailing address
3072 BRIGHTON 1ST ST, BROOKLYN, NY 11235-8009
(718) 265-0707
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B01256
LICENSE
NY
Enumeration date
05/21/2009
Last updated
05/21/2009
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