# THE MORTLAKE FIRE COMPANY OF BROOKLYN CONNECTICUT INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285629964
- **Authorized official:** LUCIEN BRODEUR (CHIEF)
- **Authorized official phone:** (860) 774-2032

## Contact information

- **Practice address:** 12 CANTERBURY RD, BROOKLYN, CT 06234-1902
- **Practice address phone:** (860) 774-2032
- **Mailing address:** 269 MAIN ST, CROMWELL, CT 06416-2302
- **Mailing address phone:** (860) 638-1800
- **Mailing address fax:** (860) 638-1802

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 09/19/2005
- **Last updated:** 01/09/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004094538 | — | CT |
| 01 | — | 590006253 | RAILROAD MEDICARE | — |
| 01 | — | 710C019B1CT01 | BLUE CROSS/BLUE SHIELD | — |