=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285461590
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SYOSSET FIRE DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/19/2024
-----------------------------------------------------
Last Update Date | 09/19/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 50 COLD SPRING RD
-----------------------------------------------------
City | SYOSSET
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11791-3113
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-677-4506
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 50 COLD SPRING RD
-----------------------------------------------------
City | SYOSSET
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11791-3113
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-677-4506
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | TREASURER
-----------------------------------------------------
Name | KAREN BORRELLI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 516-677-4506
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------