Provider Demographics
NPI:1982215588
Name:TEWKSBURY FIRST AID & RESCUE SQUAD
Entity Type:Organization
Organization Name:TEWKSBURY FIRST AID & RESCUE SQUAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/LIEUTENANT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:LATTANZIO
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-B
Authorized Official - Phone:917-502-4524
Mailing Address - Street 1:5 VIEWPOINT TER
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NJ
Mailing Address - Zip Code:08833-4379
Mailing Address - Country:US
Mailing Address - Phone:917-502-4524
Mailing Address - Fax:
Practice Address - Street 1:163 OLD TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:CALIFON
Practice Address - State:NJ
Practice Address - Zip Code:07830-3039
Practice Address - Country:US
Practice Address - Phone:908-439-9311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance