Organization
TICONDEROGA EMERGENCY SQUAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA A COOK (MEDICAL LT.)
(518) 503-5055
Entity
Organization
Contact information
Practice address
118 CHAMPLAIN AVENUE, TICONDEROGA, NY 12883
(518) 503-5055
(518) 391-2601
Mailing address
PO BOX 265, TICONDEROGA, NY 12883-0265
(518) 503-5055
(518) 391-2601
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
10140
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01629978
—
NY
01
—
700010
MVP
—
01
—
9602724
GHI
—
Enumeration date
09/16/2006
Last updated
12/10/2012
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