Provider Demographics
NPI:1285627018
Name:TOWN OF MAMARONECK
Entity type:Organization
Organization Name:TOWN OF MAMARONECK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE DISTRICT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:LIVERZANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-381-7838
Mailing Address - Street 1:PO BOX 26941
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-6941
Mailing Address - Country:US
Mailing Address - Phone:914-381-7838
Mailing Address - Fax:914-381-7809
Practice Address - Street 1:740 W BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-3345
Practice Address - Country:US
Practice Address - Phone:914-381-7838
Practice Address - Fax:914-381-7809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10175341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01499985Medicaid
NYA55031Medicare ID - Type Unspecified