Provider Demographics
NPI:1952500449
Name:SOUND SHORE AMBULETTE CORP
Entity Type:Organization
Organization Name:SOUND SHORE AMBULETTE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-285-0100
Mailing Address - Street 1:175 MAIN ST
Mailing Address - Street 2:SUITE 0711-06
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-3105
Mailing Address - Country:US
Mailing Address - Phone:914-285-0100
Mailing Address - Fax:
Practice Address - Street 1:175 MAIN ST
Practice Address - Street 2:SUITE 0711-06
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-3105
Practice Address - Country:US
Practice Address - Phone:914-285-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY35955343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02524569Medicaid