Provider Demographics
NPI:1871364612
Name:SUNNY SHOT L.L.C
Entity type:Organization
Organization Name:SUNNY SHOT L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBR
Authorized Official - Prefix:
Authorized Official - First Name:DMITRII
Authorized Official - Middle Name:
Authorized Official - Last Name:SOSHNIKOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-571-4716
Mailing Address - Street 1:9037 52ND AVE APT 3F
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4026
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9037 52ND AVE APT 3F
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4026
Practice Address - Country:US
Practice Address - Phone:929-571-4716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle