Organization
RAVENA RESCUE SQUAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN DUNICAN (AUTHORIZED AGENT)
(888) 603-2455
Entity
Organization
Contact information
Practice address
1 BRUNO BLVD, RAVENA, NY 12143-1625
(518) 756-2096
(518) 756-6015
Mailing address
107 WASHINGTON AVE, ALBANY, NY 12210-2231
(888) 603-2455
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
0468
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01903488
—
NY
01
—
5900012637
RAILROAD MEDICARE
—
Enumeration date
10/26/2005
Last updated
08/13/2019
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