Healthcare Provider Details

I. General information

NPI: 1346248069
Provider Name (Legal Business Name): FIRST RESPONSE AMBULANCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 08/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 BAYVIEW AVE
INWOOD NY
11096-1701
US

IV. Provider business mailing address

455 BAYVIEW AVE
INWOOD NY
11096-1701
US

V. Phone/Fax

Practice location:
  • Phone: 516-239-1032
  • Fax: 516-239-4040
Mailing address:
  • Phone: 516-239-1032
  • Fax: 516-239-4040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0668
License Number StateNY

VIII. Authorized Official

Name: MR. SAMUEL MEZRAHI
Title or Position: OWNER
Credential:
Phone: 516-239-1032