Provider Demographics
NPI:1083027791
Name:GENERAL AMBULETTE
Entity Type:Organization
Organization Name:GENERAL AMBULETTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TORIBIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-332-5577
Mailing Address - Street 1:1563 BOONE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-5660
Mailing Address - Country:US
Mailing Address - Phone:718-842-8819
Mailing Address - Fax:718-842-8818
Practice Address - Street 1:1563 BOONE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-5660
Practice Address - Country:US
Practice Address - Phone:718-842-8819
Practice Address - Fax:718-842-8818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01037594343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01037594Medicaid