Provider Demographics
NPI:1801879705
Name:EASTON-GREENWICH RESCUE SQUAD , INC
Entity type:Organization
Organization Name:EASTON-GREENWICH RESCUE SQUAD , INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANUSZEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-692-7118
Mailing Address - Street 1:PO BOX 535
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-0535
Mailing Address - Country:US
Mailing Address - Phone:315-635-1789
Mailing Address - Fax:315-635-3289
Practice Address - Street 1:441 STATE ROUTE 29
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:NY
Practice Address - Zip Code:12834-4233
Practice Address - Country:US
Practice Address - Phone:518-692-7118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY09473341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
9602715OtherGHI
NY01786025Medicaid
10028536OtherCDPHP
590011581OtherPALMETTO GBA RAILROAD
960189OtherMVP
NY01786025Medicaid