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General NPI Number Information
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NPI Number | 1700481173
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Entity Type | Organization
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Legal Business Name | BRENTWOOD LEGION AMBULANCE SERVICE INC
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Dates
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Enumeration Date | 12/02/2020
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 29 THIRD AVENUE
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City | BRENTWOOD
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State | NY
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Zip | 11717
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Country | US
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Telephone | 631-273-3701
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Fax | 631-951-4513
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Provider Business Mailing Address
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Address Line | 8610 MAIN STREET
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-7455
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Country | US
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Telephone | 716-204-3350
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Fax | 716-247-5274
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Authorized Official
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Title or Position | PRESIDENT
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Name | FRANCISCO MARTINEZ
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Credential |
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Telephone | 631-273-3701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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