Healthcare Provider Details

I. General information

NPI: 1871866491
Provider Name (Legal Business Name): GARY W FRIOT EMT-CC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2012
Last Update Date: 02/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 RENSSELAER ST
RENSSELAER FALLS NY
13680-3182
US

IV. Provider business mailing address

PO BOX 164
RENSSELAER FALLS NY
13680-0164
US

V. Phone/Fax

Practice location:
  • Phone: 315-344-8853
  • Fax: 315-344-7068
Mailing address:
  • Phone: 315-854-4418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number139451
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: