Healthcare Provider Details

I. General information

NPI: 1174683056
Provider Name (Legal Business Name): NORTH SHORE AMBULANCE&OXYGEN SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 06/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11018 CORONA AVE
CORONA NY
11368-4029
US

IV. Provider business mailing address

11018 CORONA AVE
CORONA NY
11368-4029
US

V. Phone/Fax

Practice location:
  • Phone: 718-458-9300
  • Fax: 718-699-4321
Mailing address:
  • Phone: 718-458-9300
  • Fax: 718-699-4321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number7360
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberB90162
License Number StateNY

VIII. Authorized Official

Name: MR. ANTHONY TUFARO
Title or Position: CEO
Credential:
Phone: 718-458-9300