Organization
SUBURBAN TRANSPORTATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL F. ILACQUA (PRESIDENT)
(315) 437-0058
Entity
Organization
Contact information
Practice address
6327 E MOLLOY RD, EAST SYRACUSE, NY 13057-1023
(315) 437-0058
(315) 437-5267
Mailing address
6327 E MOLLOY RD, EAST SYRACUSE, NY 13057-1023
(315) 437-0058
(315) 437-5267
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
NY
344600000X
Taxi
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01261870
—
NY
01
—
091110000109
FIDELIS CARE NEW YORK
NY
Enumeration date
06/25/2007
Last updated
07/20/2010
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