Organization
LITTLE NECK-DOUGLASTON COMMUNITY AMBULANCE CORP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY T GENTILE (AUTHORIZED AGENT)
(860) 257-9201
Entity
Organization
Contact information
Practice address
4218 MARATHON PKWY, LITTLE NECK, NY 11363-1935
(718) 229-0400
Mailing address
PO BOX 290184, WETHERSFIELD, CT 06129-0184
(860) 257-9201
(860) 721-6362
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
7354
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01487952
—
NY
01
—
1487645222
RAILROAD MEDICARE
NY
Enumeration date
11/01/2005
Last updated
03/09/2009
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