Organization
WANTAGH LEVITTOWN VOL AMB CORPS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HEATHER M LIZOTTE (AUTHORIZED AGENT)
(800) 452-8191
Entity
Organization
Contact information
Practice address
129 BALSAM LN, LEVITTOWN, NY 11756-4901
(516) 520-3002
(516) 731-3411
Mailing address
PO BOX 290184, WETHERSFIELD, CT 06129-0184
(800) 452-8191
(860) 721-6362
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
2933
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01981300
—
NY
Enumeration date
10/10/2005
Last updated
08/22/2020
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