Healthcare Provider Details

I. General information

NPI: 1245211671
Provider Name (Legal Business Name): BRIGHTON VOLUNTEER AMBULANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2005
Last Update Date: 01/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 WINTON ROAD S.
ROCHESTER NY
14618-3909
US

IV. Provider business mailing address

5530 SHERIDAN DRIVE SUITE 3B
WILLIAMSVILLE NY
14221-3730
US

V. Phone/Fax

Practice location:
  • Phone: 585-271-2718
  • Fax: 585-271-3258
Mailing address:
  • Phone: 716-204-3350
  • Fax: 716-247-5474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number09718
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number31913
License Number StateNY

VIII. Authorized Official

Name: BARBARA SFORZA
Title or Position: BUSINESS MANAGER
Credential:
Phone: 585-271-2718