Provider Demographics
NPI:1154170819
Name:RENSSELAER POLYTECHNIC INSTITUTE AMBULANCE
Entity type:Organization
Organization Name:RENSSELAER POLYTECHNIC INSTITUTE AMBULANCE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:QA/QI COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-900-7742
Mailing Address - Street 1:92 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-3525
Mailing Address - Country:US
Mailing Address - Phone:518-900-7742
Mailing Address - Fax:
Practice Address - Street 1:110 8TH ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-3522
Practice Address - Country:US
Practice Address - Phone:518-900-7742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RENSSELAER POLYTECHNIC INSTITUTENX
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-15
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance