Organization
EASTERN LONG ISLAND TRANSPORTATION ENT.
Active
Other names
Elite Transport
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY J RYAN (PRESIDENT)
(631) 732-6400
Entity
Organization
Contact information
Practice address
269 MIDDLE ISLAND RD, MEDFORD, NY 11763-1507
(631) 732-6400
(631) 732-6416
Mailing address
46 PENTMOOR DR, MASTIC, NY 11950-1606
(631) 281-0849
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01416260
—
NY
Enumeration date
02/14/2007
Last updated
08/22/2020
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