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General NPI Number Information
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NPI Number | 1962726638
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Entity Type | Organization
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Legal Business Name | MONTCLAIR AMBULANCE UNIT
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Dates
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Enumeration Date | 03/24/2010
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Last Update Date | 03/24/2010
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Provider Practice Location Address
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Address Line | 95 WALNUT ST
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City | MONTCLAIR
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State | NJ
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Zip | 07042-4038
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Country | US
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Telephone | 973-783-7624
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 868
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City | VOORHEES
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State | NJ
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Zip | 08043-0868
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Country | US
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Telephone | 856-784-8004
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Fax | 856-768-2739
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Authorized Official
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Title or Position | PRESIDENT
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Name | JONATHAN HIRSH
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Credential |
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Telephone | 973-783-7624
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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 | M0711014
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License Number State | NJ
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