Organization
CONSTABLEVILLE VOLUNTEER FIRE
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
MAIN ST, CONSTABLEVILLE, NY 13325-0438
(315) 397-2828
(315) 942-6494
Mailing address
PO BOX 290184, WETHERSFIELD, CT 06129-0184
(800) 452-8191
(860) 563-3403
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
2412
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02022071
—
NY
01
—
P00052477
RAILROAD MEDICARE
—
Enumeration date
10/12/2005
Last updated
11/21/2011
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