Provider Demographics
NPI:1336387471
Name:VILLAGE OF NEW SQUARE
Entity Type:Organization
Organization Name:VILLAGE OF NEW SQUARE
Other - Org Name:VILLAGE OF NEW SQUARE
Other - Org Type:Other Name
Authorized Official - Title/Position:EMS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BREUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-364-1000
Mailing Address - Street 1:48 BAKERTOWN RD
Mailing Address - Street 2:SUITE 407
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-8428
Mailing Address - Country:US
Mailing Address - Phone:845-781-2403
Mailing Address - Fax:845-781-2424
Practice Address - Street 1:766 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-1985
Practice Address - Country:US
Practice Address - Phone:845-354-1000
Practice Address - Fax:845-354-7282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-28
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11777341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance