Provider Demographics
NPI:1871108548
Name:ALL-STAR TAXI LLC
Entity type:Organization
Organization Name:ALL-STAR TAXI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-882-4000
Mailing Address - Street 1:825 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-7201
Mailing Address - Country:US
Mailing Address - Phone:631-303-9333
Mailing Address - Fax:631-676-7730
Practice Address - Street 1:825 S 2ND ST
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-7201
Practice Address - Country:US
Practice Address - Phone:631-882-4000
Practice Address - Fax:631-676-7730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06082562Medicaid