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Organization
THE MORTLAKE FIRE COMPANY OF BROOKLYN CONNECTICUT INC
Active
Organization
THE MORTLAKE FIRE COMPANY OF BROOKLYN CONNECTICUT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCIEN BRODEUR (CHIEF)
(860) 774-2032
Entity
Organization
Contact information
Practice address
12 CANTERBURY RD, BROOKLYN, CT 06234-1902
(860) 774-2032
Mailing address
269 MAIN ST, CROMWELL, CT 06416-2302
(860) 638-1800
(860) 638-1802
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004094538
—
CT
01
—
590006253
RAILROAD MEDICARE
—
01
—
710C019B1CT01
BLUE CROSS/BLUE SHIELD
—
Enumeration date
09/19/2005
Last updated
01/09/2010
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