Citicoach, Inc.

Primary specialty

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

License

B90348 Issued in NY

Legal business name

CITICOACH, INC.

Doing business as

Tripway Services

Practice address

551 Grand St RM 5
New York, NY 10002-4282

Phone

(212) 777-1277

NPI assigned

Nov 16, 2006

Last updated

Aug 22, 2020By 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. Dmitriy Nemenov

Title

President

Phone

(212) 777-1277

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tripway Services Doing business as

Locations

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417020603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 GRAND ST RM 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100024282",
            "telephone_number": "212-777-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 GRAND ST RM 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100024282",
            "telephone_number": "212-777-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITICOACH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NEMENOV",
        "authorized_official_first_name": "DMITRIY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-777-1277",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NY",
            "license": "B90348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02622062",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tripway Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Non-emergency Medical Transport (VAN) in New York, NY
• Providers in New York, NY by specialty
• Non-emergency Medical Transport (VAN) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.