Provider Demographics
NPI:1831172006
Name:CLIFTON PARK & HALFMOON EMERGENCY CORPS INC
Entity type:Organization
Organization Name:CLIFTON PARK & HALFMOON EMERGENCY CORPS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:JANIKAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-371-3880
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 1:15 CROSSINGS BLVD
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065
Practice Address - Country:US
Practice Address - Phone:518-371-3880
Practice Address - Fax:518-371-7623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY09595341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
712009OtherMVP
000400567001OtherBS OF NORTHEASTERN NY
10014332OtherCDPHP
NY01547488Medicaid
9610573OtherGHI
000400567001OtherBS OF NORTHEASTERN NY
NY01547488Medicaid