Organization
FOURY4
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD MABROUK (OWNER)
(315) 746-1601
Entity
Organization
Contact information
Practice address
5100 HIGHBRIDGE ST APT 31A, FAYETTEVILLE, NY 13066-2445
(315) 746-1601
Mailing address
5100 HIGHBRIDGE ST APT 31A, FAYETTEVILLE, NY 13066-2445
(315) 746-1601
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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