Provider Demographics
NPI:1255971545
Name:KALUMA TRANSPORTATIOIN GROUP
Entity type:Organization
Organization Name:KALUMA TRANSPORTATIOIN GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-543-7771
Mailing Address - Street 1:3107 KINGSBRIDGE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3901
Mailing Address - Country:US
Mailing Address - Phone:718-543-7771
Mailing Address - Fax:
Practice Address - Street 1:3107 KINGSBRIDGE AVE FL 2
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3901
Practice Address - Country:US
Practice Address - Phone:718-543-7771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-14
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB02997OtherNYC TLC
NY04782656Medicaid