Augustus Amasha

Individual provider Active NPI Non-emergency Medical Transport (VAN) · Latham, NY

NPI 1043699655 · NPPES record last updated May 28, 2015

Key facts

NPI
1043699655
Entity type
Individual (NPI type 1)
Primary specialty
Non-emergency Medical Transport (VAN) 343900000X
License
38057 (NY)
Practice address
952 Troy Schenectady Rd
Suite #: 103
Latham, NY 12110-1612
Phone
(518) 250-4664
Fax
(518) 250-4665
NPI assigned
May 28, 2015
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
38057NYMDNon-emergency Medical Transport (VAN)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X 38057 NY Yes

Addresses

Primary practice location

952 Troy Schenectady Rd
Suite #: 103
Latham, NY 12110-1612

Mailing address

952 Troy Schenectady Rd
Suite #: 103
Latham, NY 12110-1612
Phone (518) 250-4664

Other identifiers

IdentifierTypeStateIssuer
03280926MedicaidNY

Other providers in Latham, NY

All providers in Latham, NY · Non-emergency Medical Transport (VAN) in New York

Sources for this page

Verify at the official NPI Registry.