Organization
VILLAGE OF BROCKPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN RAY (ADMINISTRATOR)
(585) 768-2192
Entity
Organization
Contact information
Practice address
49 STATE ST, BROCKPORT, NY 14420-1921
(585) 768-2192
Mailing address
PO BOX 186, LE ROY, NY 14482-0186
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
2717
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02099576
—
NY
01
—
PVILLOFBROC
MONROE PLANS
NY
Enumeration date
02/28/2006
Last updated
03/14/2008
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