Provider Demographics
NPI:1134161870
Name:CONGERS VALLEY COTTAGE VOLUNTEER AMBULANCE CORPS INC
Entity type:Organization
Organization Name:CONGERS VALLEY COTTAGE VOLUNTEER AMBULANCE CORPS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:PANOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-698-4873
Mailing Address - Street 1:122 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:CONGERS
Mailing Address - State:NY
Mailing Address - Zip Code:10920-2238
Mailing Address - Country:US
Mailing Address - Phone:845-268-7333
Mailing Address - Fax:845-268-5919
Practice Address - Street 1:122 KINGS HWY
Practice Address - Street 2:
Practice Address - City:CONGERS
Practice Address - State:NY
Practice Address - Zip Code:10920-2238
Practice Address - Country:US
Practice Address - Phone:845-268-7333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01434977Medicaid
NYA08151Medicare ID - Type Unspecified