Provider Demographics
NPI:1346248069
Name:FIRST RESPONSE AMBULANCE, INC.
Entity Type:Organization
Organization Name:FIRST RESPONSE AMBULANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEZRAHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-239-1032
Mailing Address - Street 1:455 BAYVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:INWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11096-1701
Mailing Address - Country:US
Mailing Address - Phone:516-239-1032
Mailing Address - Fax:516-239-4040
Practice Address - Street 1:455 BAYVIEW AVE
Practice Address - Street 2:
Practice Address - City:INWOOD
Practice Address - State:NY
Practice Address - Zip Code:11096-1701
Practice Address - Country:US
Practice Address - Phone:516-239-1032
Practice Address - Fax:516-239-4040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY06683416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02291725Medicaid
NY02291725Medicaid