Healthcare Provider Details

I. General information

NPI: 1730667734
Provider Name (Legal Business Name): LAGRANGE FIRE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2018
Last Update Date: 10/03/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 FREEDOM PLAINS ROAD
POUGHKEEPSIE NY
12603-2678
US

IV. Provider business mailing address

504 FREEDOM PLAINS ROAD
POUGHKEEPSIE NY
12603-2678
US

V. Phone/Fax

Practice location:
  • Phone: 845-471-4693
  • Fax: 845-452-3349
Mailing address:
  • Phone: 845-471-4693
  • Fax: 845-452-3349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number1319
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. RICHARD SASSI
Title or Position: FIRE COMMISSIONER
Credential:
Phone: 845-452-4998