Individual
MIGUEL BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5 LAIDLAW AVE APT 105, JERSEY CITY, NJ 07306-1550
(646) 578-0037
Mailing address
392 CENTRAL AVE UNIT 7806, JERSEY CITY, NJ 07307-7623
(201) 952-1269
(201) 526-7308
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
B50095470001842
NJ
172A00000X
Driver
—
—
342000000X
Transportation Network Company
B50095470001842
NJ
342000000X
Transportation Network Company
—
—
343900000X
Non-emergency Medical Transport (VAN)
B50095470001842
NJ
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
B50095470001842
NJ
347E00000X
Transportation Broker
B50095470001842
NJ
347E00000X
Transportation Broker
—
—
Other
Enumeration date
10/22/2021
Last updated
10/22/2021
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