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General NPI Number Information
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NPI Number | 1982215588
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Entity Type | Organization
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Legal Business Name | TEWKSBURY FIRST AID & RESCUE SQUAD
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Dates
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Enumeration Date | 08/17/2020
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Last Update Date | 08/17/2020
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Provider Practice Location Address
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Address Line | 163 OLD TURNPIKE RD
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City | CALIFON
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State | NJ
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Zip | 07830-3039
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Country | US
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Telephone | 908-439-9311
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Fax |
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Provider Business Mailing Address
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Address Line | 5 VIEWPOINT TER
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City | LEBANON
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State | NJ
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Zip | 08833-4379
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Country | US
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Telephone | 917-502-4524
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT/LIEUTENANT
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Name | MR. GREGORY LATTANZIO
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Credential | EMT-B
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Telephone | 917-502-4524
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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 |
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License Number State |
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