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General NPI Number Information
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NPI Number | 1497737381
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Entity Type | Organization
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Legal Business Name | PORT CHESTER-RYE-RYE BROOK EMERGENCY MEDICAL SERVICES INC
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 07/17/2019
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Provider Practice Location Address
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Address Line | 417 ELLENDALE AVE
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City | PORT CHESTER
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State | NY
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Zip | 10573-3533
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Country | US
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Telephone | 914-939-8112
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Fax | 914-939-1075
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Provider Business Mailing Address
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Address Line | 417 ELLENDALE AVE
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City | PORT CHESTER
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State | NY
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Zip | 10573-3533
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Country | US
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Telephone | 914-939-8112
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Fax | 914-939-1075
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. SCOTT MOORE
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Credential | PARAMEDIC
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Telephone | 914-939-8112
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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 | 09930
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License Number State | NY
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