Private Escort Service Inc.

Primary specialty

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

License

29953 Issued in NY

Legal business name

PRIVATE ESCORT SERVICE INC.

Doing business as

Brooklyn Express

Practice address

1261 Ralph Ave
Brooklyn, NY 11236-1415

Phone

(718) 629-6520

Fax

(718) 629-6524

NPI assigned

Dec 2, 2006

Organization subpart

No

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

Authorized official

Name

Everett Breland

Title

President

Phone

(718) 629-6520

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brooklyn Express Doing business as

Locations

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699843961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 RALPH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112361415",
            "telephone_number": "718-629-6520",
            "fax_number": "718-629-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 RALPH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112361415",
            "telephone_number": "718-629-6520",
            "fax_number": "718-629-6524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE ESCORT SERVICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRELAND",
        "authorized_official_first_name": "EVERETT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-629-6520"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NY",
            "license": "29953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00813061",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brooklyn Express",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Non-emergency Medical Transport (VAN) in Brooklyn, NY
• Providers in Brooklyn, 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.