Healthcare Provider Details

I. General information

NPI: 1184600454
Provider Name (Legal Business Name): PRINCETON FIRST AID AND RESCUE SQUAD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 05/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 N HARRISON ST
PRINCETON NJ
08540-3515
US

IV. Provider business mailing address

PO BOX 207
ALLENTOWN PA
18105-0207
US

V. Phone/Fax

Practice location:
  • Phone: 609-924-3338
  • Fax: 609-924-3335
Mailing address:
  • Phone: 484-664-2007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberPRN05007
License Number StateNJ

VIII. Authorized Official

Name: MARK FREDA
Title or Position: PRESIDENT
Credential:
Phone: 609-924-3338