Provider Demographics
NPI:1326022955
Name:CAMBRIDGE VALLEY RESCUE SQUAD INC
Entity Type:Organization
Organization Name:CAMBRIDGE VALLEY RESCUE SQUAD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIEZIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-677-8211
Mailing Address - Street 1:PO BOX 535
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-0535
Mailing Address - Country:US
Mailing Address - Phone:315-635-1789
Mailing Address - Fax:315-635-3289
Practice Address - Street 1:37 GILBERT ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:NY
Practice Address - Zip Code:12816-2618
Practice Address - Country:US
Practice Address - Phone:518-677-8211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-06
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10346341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
10013784OtherCDPHP
3200064OtherGHI
702111OtherMVP
590008207OtherPALMETTO RAILROAD MEDICAR
NY01629643Medicaid
000400169001OtherBS OF NENY
VT1011656OtherVT EDS MEDICAID
NY54107BMedicare ID - Type Unspecified