Healthcare Provider Details

I. General information

NPI: 1679550982
Provider Name (Legal Business Name): RICHMOND COUNTY AMBULANCE SERVICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 09/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1355 CASTLETON AVE
STATEN ISLAND NY
10310-1704
US

IV. Provider business mailing address

1355 CASTLETON AVE
STATEN ISLAND NY
10310-1704
US

V. Phone/Fax

Practice location:
  • Phone: 718-273-7703
  • Fax: 718-273-7479
Mailing address:
  • Phone: 718-273-7703
  • Fax: 718-273-7479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number09966
License Number StateNY

VIII. Authorized Official

Name: MR. ELIEZER C GEWIRTZMAN
Title or Position: CEO
Credential:
Phone: 718-273-7703