Provider Demographics
NPI:1871706929
Name:G&M AMBULETTE SERVICE INC
Entity type:Organization
Organization Name:G&M AMBULETTE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ZOLTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-946-2121
Mailing Address - Street 1:1550 MCDONALD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5594
Mailing Address - Country:US
Mailing Address - Phone:718-946-2121
Mailing Address - Fax:718-946-1866
Practice Address - Street 1:1550 MCDONALD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5594
Practice Address - Country:US
Practice Address - Phone:718-946-2121
Practice Address - Fax:718-946-1866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01450797Medicaid