Provider Demographics
NPI:1073836524
Name:LOVEDALE AMBULETTE INC
Entity Type:Organization
Organization Name:LOVEDALE AMBULETTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:P
Authorized Official - Last Name:MUNDACKAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-576-4800
Mailing Address - Street 1:280 DOBBSFERY RD # 304
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10607
Mailing Address - Country:US
Mailing Address - Phone:914-576-4800
Mailing Address - Fax:914-576-4014
Practice Address - Street 1:280 DOBBSFERY RD # 304
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607
Practice Address - Country:US
Practice Address - Phone:914-576-4800
Practice Address - Fax:914-576-4014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-11
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343900000X343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02408717Medicaid