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General NPI Number Information
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NPI Number | 1710741830
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Entity Type | Organization
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Legal Business Name | 1ST CHOICE MD EMS
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Dates
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Enumeration Date | 02/08/2024
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 36 RUSS ST FL 537
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City | HARTFORD
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State | CT
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Zip | 06106-1520
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Country | US
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Telephone | 860-775-7589
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Fax |
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Provider Business Mailing Address
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Address Line | 36 RUSS ST FL 537
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City | HARTFORD
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State | CT
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Zip | 06106-1520
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAKKARA BOGLE-ASSEGAI
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Credential | MD
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Telephone | 347-475-9525
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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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