Provider Demographics
NPI:1386737336
Name:VILLAGE OF SLEEPY HOLLOW
Entity type:Organization
Organization Name:VILLAGE OF SLEEPY HOLLOW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIACCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-452-8191
Mailing Address - Street 1:P.O. BOX 519
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-0519
Mailing Address - Country:US
Mailing Address - Phone:914-366-4004
Mailing Address - Fax:914-366-4111
Practice Address - Street 1:29 ANDREWS LN
Practice Address - Street 2:
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-2221
Practice Address - Country:US
Practice Address - Phone:914-631-1962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2018-01-19
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2007-08-31
Provider Licenses
StateLicense IDTaxonomies
NY5949341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02365319Medicaid
NYA52482Medicare PIN