Renaissance Invalid Coach

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

RENA00492 Issued in NJ

Legal business name

RENAISSANCE INVALID COACH

Practice address

226 Lincoln Ave
# 10
Newark, NJ 07104-3452

Phone

(973) 497-0045

Fax

(973) 497-1155

NPI assigned

May 10, 2007

Last updated

Jul 26, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mojtaba Gusemalseed, CPR, MAVT

Title

Owner

Phone

(973) 497-0045

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217030400000",
    "number": "1346454113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22711",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071012711",
            "telephone_number": "973-497-0045",
            "fax_number": "973-497-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 LINCOLN AVE",
            "address_2": "# 10",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071043452",
            "telephone_number": "973-497-0045",
            "fax_number": "973-497-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE INVALID COACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2008-07-26",
        "status": "A",
        "authorized_official_last_name": "GUSEMALSEED",
        "authorized_official_first_name": "MOJTABA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-497-0045",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPR, MAVT"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NJ",
            "license": "RENA00492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7356501",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Newark, NJ
• Providers in Newark, NJ by specialty
• Non-emergency Medical Transport (VAN) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.