Organization
CITY OF UTICA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL BROOKS (CHIEF)
(585) 768-2192
Entity
Organization
Contact information
Practice address
1217 PARK AVE, 1 KENNEDY PLAZA, UTICA, NY 13501-3807
(585) 768-2192
Mailing address
PO BOX 186, LE ROY, NY 14482-0186
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
6209
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02717848
—
NY
01
—
P00251125
MEDICARE RAILROAD
NY
Enumeration date
03/01/2006
Last updated
04/22/2008
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