=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982148003
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMBULNZ NY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/08/2016
-----------------------------------------------------
Last Update Date | 02/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1670 WEIRFIELD ST
-----------------------------------------------------
City | RIDGEWOOD
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11385-5350
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-433-2592
-----------------------------------------------------
Fax | 718-239-4900
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 685 3RD AVE FL 9
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10017-4151
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 844-443-6246
-----------------------------------------------------
Fax | 833-907-2235
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF FINANCE
-----------------------------------------------------
Name | ROBERT MBONYE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 585-278-0502
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------