Healthcare Provider Details

I. General information

NPI: 1144279126
Provider Name (Legal Business Name): BEDFORD STUYVESANT VOLUNTEER AMBULANCE CORPS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 GREENE AVE
BROOKLYN NY
11221-1904
US

IV. Provider business mailing address

48 BAKERTOWN RD STE 303
MONROE NY
10950-8432
US

V. Phone/Fax

Practice location:
  • Phone: 718-453-4617
  • Fax:
Mailing address:
  • Phone: 845-781-2440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number09905
License Number StateNY

VIII. Authorized Official

Name: ANTOINE ROBINSON
Title or Position: PRESIDENT
Credential:
Phone: 718-453-4617