Provider Demographics
NPI:1073553723
Name:NEW CITY VOLUNTEER AMBULANCE CORPS RESCUE SQUAD, INC
Entity Type:Organization
Organization Name:NEW CITY VOLUNTEER AMBULANCE CORPS RESCUE SQUAD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-634-3433
Mailing Address - Street 1:PO BOX 8000, DEPT 538
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14267-0001
Mailing Address - Country:US
Mailing Address - Phone:610-401-2041
Mailing Address - Fax:610-401-2100
Practice Address - Street 1:200 CONGERS RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-6256
Practice Address - Country:US
Practice Address - Phone:845-634-3433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01455316Medicaid
NY01455316Medicaid