Provider Demographics
NPI:1679550982
Name:RICHMOND COUNTY AMBULANCE SERVICE, INC
Entity Type:Organization
Organization Name:RICHMOND COUNTY AMBULANCE SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIEZER
Authorized Official - Middle Name:C
Authorized Official - Last Name:GEWIRTZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-273-7703
Mailing Address - Street 1:1355 CASTLETON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-1704
Mailing Address - Country:US
Mailing Address - Phone:718-273-7703
Mailing Address - Fax:718-273-7479
Practice Address - Street 1:1355 CASTLETON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-1704
Practice Address - Country:US
Practice Address - Phone:718-273-7703
Practice Address - Fax:718-273-7479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY099663416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01020777Medicaid
590111031Medicare PIN
NYA59591Medicare PIN
NYA59591Medicare PIN