Organization
QUEENS VILLAGE HOLLIS BELLEROSE VOLUNTEER AMBULANCE CORPS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY T GENTILE (AUTHORIZED AGENT)
(800) 452-8191
Entity
Organization
Contact information
Practice address
23501 BRADDOCK AVE, QUEENS VILLAGE, NY 11428-1439
(718) 244-3511
Mailing address
PO BOX 290184, WETHERSFIELD, CT 06129-0184
(800) 452-8181
(860) 563-3403
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
7363
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02859149
—
NY
01
—
P00682181
RAILROAD MEDICARE
NY
Enumeration date
06/04/2006
Last updated
04/25/2011
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