Berkshire Emergency Squad Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0680 Issued in NY

Legal business name

BERKSHIRE EMERGENCY SQUAD INC

Doing business as

Northern Tioga Emergency Medical Services

Practice address

9 Park Street
Suite C
Newark Valley, NY 13811-0506

Phone

(607) 642-3451

Fax

(607) 642-5036

NPI assigned

Feb 7, 2007

Last updated

Jan 15, 2015By 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

Cheryl L Galluzzo

Title

Director Authorized Official

Phone

(607) 642-3451

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Northern Tioga Emergency Medical Services Doing business as

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421280000000",
    "number": "1992845085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8020 E MAIN RD",
            "city": "LE ROY",
            "state": "NY",
            "postal_code": "144829704",
            "telephone_number": "800-716-8015",
            "fax_number": "585-768-7323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 PARK STREET",
            "address_2": "SUITE C",
            "city": "NEWARK VALLEY",
            "state": "NY",
            "postal_code": "138110506",
            "telephone_number": "607-642-3451",
            "fax_number": "607-642-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKSHIRE EMERGENCY SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2015-01-15",
        "status": "A",
        "authorized_official_last_name": "GALLUZZO",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "607-642-3451"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NY",
            "license": "0680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02368069",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Tioga Emergency Medical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michele Ann Anderson, RN
• Patricia A Blazey, OTR
• Cassandra Paige Coombs, LPN
• Melanie E Coombs, P.T.
• Ryan Griffin D'Arcy
• Marsha M Dean, M.S., CCC-SLP

• Land Ambulance in Newark Valley, NY
• Providers in Newark Valley, 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 Jan 15, 2015; 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.