Healthcare Provider Details

I. General information

NPI: 1356607402
Provider Name (Legal Business Name): ACCESS AMBULETTE SERVICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2012
Last Update Date: 04/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 E SANDFORD BLVD
MOUNT VERNON NY
10550-4524
US

IV. Provider business mailing address

PO BOX 3659
MOUNT VERNON NY
10553-3659
US

V. Phone/Fax

Practice location:
  • Phone: 718-220-0987
  • Fax: 914-664-1410
Mailing address:
  • Phone: 718-220-0987
  • Fax: 914-664-1410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number00923840
License Number StateNY

VIII. Authorized Official

Name: MR. ANTHONY PILIERO
Title or Position: MANAGER
Credential:
Phone: 718-220-0987