Clyde Fire Dept Amb Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

5814 Issued in NY

Legal business name

CLYDE FIRE DEPT AMB SERVICE

Practice address

15 Ford St
Clyde, NY 14433-1306

Phone

(315) 923-7667

Fax

(315) 923-7419

NPI assigned

Oct 11, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Heather M Lizotte

Title

Authorized Agent

Phone

(800) 452-8191

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285622654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 290184",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061290184",
            "telephone_number": "800-452-8191",
            "fax_number": "860-721-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 FORD ST",
            "city": "CLYDE",
            "state": "NY",
            "postal_code": "144331306",
            "telephone_number": "315-923-7667",
            "fax_number": "315-923-7419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLYDE FIRE DEPT AMB SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LIZOTTE",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "AUTHORIZED AGENT",
        "authorized_official_telephone_number": "800-452-8191",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NY",
            "license": "5814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01981277",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Belmontes, LMHC
• Dana Bever
• David Daniel Blasczak, MD
• Rhonda Mae Camp, RN
• Brett Carnevale, D.C.
• Clyde-Savannah Central School District
• Bridgette Colf, RN
• Karissa A Demers, M.S., CCC-SLP
• Wende Edwards, LPN
• Lisa Everett, FNP

• Land Ambulance in Clyde, NY
• Providers in Clyde, NY by specialty
• Land Ambulance in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.