Provider Demographics
NPI:1912692328
Name:PRIORITY AMBULANCE NEW YORK LLC
Entity Type:Organization
Organization Name:PRIORITY AMBULANCE NEW YORK LLC
Other - Org Name:LAKE VALLEY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF REVENUE INTEGRATION OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:JEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-597-4911
Mailing Address - Street 1:410 CATHERINE ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-1211
Mailing Address - Country:US
Mailing Address - Phone:315-724-6619
Mailing Address - Fax:
Practice Address - Street 1:24 GARDNER PL
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-2000
Practice Address - Country:US
Practice Address - Phone:518-843-1150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport