Healthcare Provider Details

I. General information

NPI: 1841856143
Provider Name (Legal Business Name): AMBULNZ NJ-PA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 05/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 W 35TH ST FL 5
NEW YORK NY
10001-2205
US

IV. Provider business mailing address

35 W 35TH ST FL 5
NEW YORK NY
10001-2205
US

V. Phone/Fax

Practice location:
  • Phone: 424-307-0744
  • Fax: 303-733-5689
Mailing address:
  • Phone: 424-307-0744
  • Fax: 303-733-5689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SCOTT WITKOWSKI
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 424-307-0744