Healthcare Provider Details

I. General information

NPI: 1972573806
Provider Name (Legal Business Name): NEWCOMB VOLUNTEER FIRE DEPT.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 09/19/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MARCY LANE
NEWCOMB NY
12852-2016
US

IV. Provider business mailing address

107 WASHINGTON AVE
ALBANY NY
12210-2231
US

V. Phone/Fax

Practice location:
  • Phone: 518-582-4713
  • Fax: 518-582-4207
Mailing address:
  • Phone: 888-603-2455
  • Fax: 888-603-2455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1525
License Number StateNY

VIII. Authorized Official

Name: ERIC JAMES FITZGERALD
Title or Position: EMS CAPTAIN
Credential:
Phone: 888-603-2455