Provider Demographics
NPI:1710741830
Name:1ST CHOICE MD EMS
Entity Type:Organization
Organization Name:1ST CHOICE MD EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAKKARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGLE-ASSEGAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-475-9525
Mailing Address - Street 1:36 RUSS ST FL 537
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-1520
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:36 RUSS ST FL 537
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-1520
Practice Address - Country:US
Practice Address - Phone:860-775-7589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport