Healthcare Provider Details

I. General information

NPI: 1295771178
Provider Name (Legal Business Name): CHAPPAQUA VOLUNTEER AMBULANCE CORPS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 03/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 N GREELEY AVE
CHAPPAQUA NY
10514-2747
US

IV. Provider business mailing address

PO BOX 1
CHAPPAQUA NY
10514-0001
US

V. Phone/Fax

Practice location:
  • Phone: 914-238-3191
  • Fax:
Mailing address:
  • Phone: 914-238-3191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number10565
License Number StateNY

VIII. Authorized Official

Name: GAIL OESTREICHER
Title or Position: CAPTAIN
Credential: EMT
Phone: 914-238-2858