Provider Demographics
NPI:1417782046
Name:STORRS, WILLIAM R (EMT)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:STORRS
Suffix:
Gender:M
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 SHULER RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NY
Mailing Address - Zip Code:14513-9356
Mailing Address - Country:US
Mailing Address - Phone:315-459-3257
Mailing Address - Fax:
Practice Address - Street 1:2050 SHULER RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NY
Practice Address - Zip Code:14513-9356
Practice Address - Country:US
Practice Address - Phone:315-459-3257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY109516154172A00000X
NY397822146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No172A00000XOther Service ProvidersDriver