MEDICARE: MOHEGAN VOLUNTEER FIRE ASSOCIATION VOLUNTEER AMBULANCE CORPS INC

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
1	341600000X	Ambulance	10366	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590013205	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
2	9634358	OTHER	GHI
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	900951	OTHER	MVP

General Provider Information

NPI Number	:	1639132905
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOHEGAN VOLUNTEER FIRE ASSOCIATION VOLUNTEER AMBULANCE CORPS INC

Provider Business Mailing Address
First Line	:	PO BOX 21027
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10087-1027
Country	:	US
Telephone Number	:	914-526-1005
Fax Number	:

Provider Business Practice Location Address
First Line	:	1975 EAST MAIN ST
Second Line	:
City	:	MOHEGAN LAKE
State	:	NY
Zip	:	10547
Country	:	US
Telephone Number	:	914-526-1005
Fax Number	:	914-526-1048

Authorized Official
Title or Position	:	CHAIRPERSON
Name	:	KENNETH CHODKOWSKI
Credential	:
Telephone Number	:	914-526-1005

Provider Enumeration Date	:	04/08/2006
Last Update Date	:	06/03/2025

Similar Medicare Providers

1982810529 — DR. BRENDA CHAN OD
Practice Location Address:

3133 E MAIN ST
MOHEGAN LAKE, NY
10547-1521

Practice Phone: 914-526-1110
Practice Fax: 914-526-1112

1952283905 — KSHAMA BARAICHI
Practice Location Address:

3550 LEXINGTON AVE
MOHEGAN LAKE, NY
10547-1273

Practice Phone: 914-528-2000
Practice Fax:

1477547685 — TREETOPS REHABILITATION AND CARE CENTER
Practice Location Address:

3550 LEXINGTON AVE
MOHEGAN LAKE, NY
10547-1267

Practice Phone: 914-528-2000
Practice Fax: 914-528-9235

1821013384 — GREAT ATLANTIC & PACIFIC TEA COMPANY INC
Practice Location Address:

3105 E MAIN ST
MOHEGAN LAKE, NY
10547-1521

Practice Phone: 914-526-0240
Practice Fax: 914-526-0244

1326065558 — WAL-MART STORES EAST LP
Practice Location Address:

3133 E MAIN ST
MOHEGAN LAKE, NY
10547-1521

Practice Phone: 914-526-1105
Practice Fax:

1033122775 — DR. WANDA ESPERANZA MEJIA DDS
Practice Location Address:

1968 E. MAIN ST MOHEGAN LAKE NY 10547
MOHEGAN LAKE, NY
10547

Practice Phone: 914-526-2144
Practice Fax: 914-526-2187

Directions to “MOHEGAN VOLUNTEER FIRE ASSOCIATION VOLUNTEER AMBULANCE CORPS INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.