# WATERFORD AMBULANCE SERVICE, 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:** 1467425652
- **Authorized official:** MR. NEIL WISEMAN (PRESIDENT)
- **Authorized official phone:** (860) 389-2701

## Contact information

- **Practice address:** 454 BOSTON POST RD, WATERFORD, CT 06385-1510
- **Practice address phone:** (860) 477-9301
- **Mailing address:** PO BOX 165, BRANFORD, CT 06405-0165
- **Mailing address phone:** (860) 663-3634
- **Mailing address fax:** (860) 452-4430

## Taxonomy

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

## Other

- **Enumeration date:** 02/09/2006
- **Last updated:** 06/16/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004172897 | — | CT |
| 01 | — | 710C152A2CT01 | BLUE CROSS/BLUE SHIELD | — |