Provider Demographics
NPI:1104376433
Name:TOWN OF CLINTON
Entity Type:Organization
Organization Name:TOWN OF CLINTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TOWN SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LACLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-497-6133
Mailing Address - Street 1:PO BOX 165
Mailing Address - Street 2:23 SMITH STREET
Mailing Address - City:CHURUBUSCO
Mailing Address - State:NY
Mailing Address - Zip Code:12923-0165
Mailing Address - Country:US
Mailing Address - Phone:518-497-6133
Mailing Address - Fax:518-497-6053
Practice Address - Street 1:23 SMITH STREET
Practice Address - Street 2:
Practice Address - City:CHURUBUSCO
Practice Address - State:NY
Practice Address - Zip Code:12923-0165
Practice Address - Country:US
Practice Address - Phone:518-497-6133
Practice Address - Fax:518-497-6053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334863416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport