Provider Demographics
NPI:1780162487
Name:FIRST AID & RESCUE SQUAD, INC OF SOMERVILLE, NJ
Entity type:Organization
Organization Name:FIRST AID & RESCUE SQUAD, INC OF SOMERVILLE, NJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:PICCHIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-458-3151
Mailing Address - Street 1:21 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21 PARK AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2301
Practice Address - Country:US
Practice Address - Phone:904-526-4545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18110273416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport