Healthcare Provider Details

I. General information

NPI: 1932168390
Provider Name (Legal Business Name): MARCELLUS AMBULANCE VOLUNTEER EMERGENCY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3707 LEE MULROY RD
MARCELLUS NY
13108-9674
US

IV. Provider business mailing address

PO BOX 535
BALDWINSVILLE NY
13027-0535
US

V. Phone/Fax

Practice location:
  • Phone: 315-673-1818
  • Fax:
Mailing address:
  • Phone: 315-635-1789
  • Fax: 315-635-3289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number09824
License Number StateNY

VIII. Authorized Official

Name: STEPHEN KNAPP
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 315-494-1069