Provider Demographics
NPI:1740334044
Name:TRI-COUNTY AMBULETTE INC,
Entity type:Organization
Organization Name:TRI-COUNTY AMBULETTE INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIPAT
Authorized Official - Middle Name:
Authorized Official - Last Name:TESTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-965-7657
Mailing Address - Street 1:58 PALISADE AVE
Mailing Address - Street 2:2FL
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-3016
Mailing Address - Country:US
Mailing Address - Phone:914-965-7647
Mailing Address - Fax:914-965-4429
Practice Address - Street 1:58 PALISADE AVE
Practice Address - Street 2:2FL
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-3016
Practice Address - Country:US
Practice Address - Phone:914-965-7647
Practice Address - Fax:914-965-4429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYB90336343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00336287Medicaid