Provider Demographics
NPI:1053616797
Name:SPECIAL RADIO DISPACHER
Entity type:Organization
Organization Name:SPECIAL RADIO DISPACHER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JO-ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEJESUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-666-3939
Mailing Address - Street 1:969 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-3132
Mailing Address - Country:US
Mailing Address - Phone:212-666-3939
Mailing Address - Fax:212-666-8034
Practice Address - Street 1:969 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-3132
Practice Address - Country:US
Practice Address - Phone:212-666-3939
Practice Address - Fax:212-666-8034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYB02228344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi