Town of Esopus Volunteer Ambulance Squad Inc

Primary specialty

AmbulanceTaxonomy code 341600000X

License

5533 Issued in NY

Legal business name

TOWN OF ESOPUS VOLUNTEER AMBULANCE SQUAD INC

Practice address

1 Cross St
Ulster Park, NY 12466-0910

Phone

(845) 338-1788

NPI assigned

Oct 26, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Mary T Gentile

Title

Authorized Agent

Phone

(860) 257-9201

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288310400000",
    "number": "1366432825",
    "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": "860-257-9201",
            "fax_number": "860-721-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CROSS ST",
            "city": "ULSTER PARK",
            "state": "NY",
            "postal_code": "124660910",
            "telephone_number": "845-338-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF ESOPUS VOLUNTEER AMBULANCE SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-26",
        "last_updated": "2010-10-29",
        "status": "A",
        "authorized_official_last_name": "GENTILE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "AUTHORIZED AGENT",
        "authorized_official_telephone_number": "860-257-9201",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NY",
            "license": "5533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02709002",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Short
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• Stacey Lynn Tierney-Gabler, LMSW
• Nancy Amanda Tiffany, ATC, LAT
• Kelly D Ulrich, LMSW
• Kelsey Beth Vargas
• Susan Williams, LCSW

• Ambulance in Ulster Park, NY
• Providers in Ulster Park, NY by specialty
• Ambulance in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.