Organization
NORTH SHORE VOLUNTEER EMERGENCY SQUAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE AVERY (TREASURER)
(315) 635-1789
Entity
Organization
Contact information
Practice address
136 BRIDGE ST, CLEVELAND, NY 13042
(315) 675-3110
Mailing address
PO BOX 535, BALDWINSVILLE, NY 13027-0535
(315) 635-1789
(315) 635-3289
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
10621
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01828757
—
NY
01
—
318534
MVP
—
01
—
590012354
PALMETTO GBA
—
Enumeration date
06/21/2006
Last updated
07/27/2012
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