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NPI Code Detail

MEDICARE: GARDEN CITY PARK WATER DISTRICT

MEDICARE: GARDEN CITY PARK WATER DISTRICT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13416L0300XLand Ambulance

General Provider Information

NPI Number : 1194576140
Entity Type Code : Organization
Provider Name (Legal Business Name) : GARDEN CITY PARK WATER DISTRICT
Provider Business Mailing Address
First Line : 333 MARCUS AVE
Second Line :
City : GARDEN CITY PARK
State : NY
Zip : 11040-3400
Country : US
Telephone Number : 516-746-3194
Fax Number :
Provider Business Practice Location Address
First Line : 2264 JERICHO TPKE
Second Line :
City : GARDEN CITY PARK
State : NY
Zip : 11040-4725
Country : US
Telephone Number : 516-746-3194
Fax Number :
Authorized Official
Title or Position : SUPERVISOR
Name : MATHEW GEORGE
Credential :
Telephone Number : 516-746-3194
Provider Enumeration Date : 03/28/2024
Last Update Date : 03/28/2024

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