Ticonderoga Emergency Squad Inc

Primary specialty

AmbulanceTaxonomy code 341600000X

License

10140 Issued in NY

Legal business name

TICONDEROGA EMERGENCY SQUAD INC

Practice address

118 Champlain Avenue
Ticonderoga, NY 12883

Phone

(518) 503-5055

Fax

(518) 391-2601

NPI assigned

Sep 16, 2006

Organization subpart

No

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

Authorized official

Name

Patricia A Cook

Title

Medical LT.

Phone

(518) 503-5055

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355097600000",
    "number": "1336245083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 265",
            "city": "TICONDEROGA",
            "state": "NY",
            "postal_code": "128830265",
            "telephone_number": "518-503-5055",
            "fax_number": "518-391-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 CHAMPLAIN AVENUE",
            "city": "TICONDEROGA",
            "state": "NY",
            "postal_code": "12883",
            "telephone_number": "518-503-5055",
            "fax_number": "518-391-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TICONDEROGA EMERGENCY SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2012-12-10",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL LT.",
        "authorized_official_telephone_number": "518-503-5055"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NY",
            "license": "10140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "9602724",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01629978",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "700010",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Siddon, PHARM.D.
• Tammy Marie Snyder, L.P.N.
• Christina St Denis, RN
• Ti Taxi Inc.
• Ticonderoga Dental Plaza, PC
• Marjorie Cook Tierney, RN
• Dawn Ellen Titus, LPO
• Town of Ticonderoga Board of Education
• Emily Triplett, MD
• William R. Unwin, LCSW

• All providers in Ticonderoga, NY
• Ambulance in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.