Provider Demographics
NPI:1215928692
Name:KATONAH-BEDFORD HILLS VOLUNTEER AMBULANCE CORPS
Entity type:Organization
Organization Name:KATONAH-BEDFORD HILLS VOLUNTEER AMBULANCE CORPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEALTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-232-5872
Mailing Address - Street 1:8610 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7455
Mailing Address - Country:US
Mailing Address - Phone:716-204-3350
Mailing Address - Fax:716-247-5274
Practice Address - Street 1:160 BEDFORD ROAD
Practice Address - Street 2:
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-2309
Practice Address - Country:US
Practice Address - Phone:914-232-5872
Practice Address - Fax:914-237-1969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-03
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5945341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01470319Medicaid
590009004OtherRAILROAD MEDICARE
590009004OtherRAILROAD MEDICARE