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General NPI Number Information
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NPI Number | 1164410536
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Entity Type | Organization
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Legal Business Name | RIDGEWOOD VOLUNTEER AMBULANCE CORPS INC
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Dates
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Enumeration Date | 10/11/2005
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Last Update Date | 01/02/2013
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Provider Practice Location Address
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Address Line | 503 ONDERDONK AVE.
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City | RIDGEWOOD
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State | NY
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Zip | 11385-1862
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Country | US
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Telephone | 718-386-7230
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Fax | 718-386-7230
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Provider Business Mailing Address
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Address Line | 503 ONDERDONK AVE.
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City | RIDGEWOOD
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State | NY
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Zip | 11385-1862
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Country | US
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Telephone | 718-386-7230
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Fax | 718-386-7230
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Authorized Official
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Title or Position | CHAIRMAN
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Name | MR. KEVIN M. MAHONEY
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Credential | EMT
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Telephone | 718-386-7230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 7368
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License Number State | NY
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