Healthcare Provider Details

I. General information

NPI: 1922217132
Provider Name (Legal Business Name): TUXEDO VOLUNTEER AMBULANCE CORPS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 09/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CONTRACTORS RD
TUXEDO PARK NY
10987-4440
US

IV. Provider business mailing address

PO BOX 726
TUXEDO PARK NY
10987-0726
US

V. Phone/Fax

Practice location:
  • Phone: 845-351-4400
  • Fax: 845-351-4402
Mailing address:
  • Phone: 845-351-4400
  • Fax: 845-627-6728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number3529
License Number StateNY

VII. Legacy identifiers

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

VIII. Authorized Official

Name: JOHN KILDUFF
Title or Position: PRESIDENT
Credential:
Phone: 845-351-4400