Provider Demographics
NPI:1912969403
Name:EMERGACARE NY LLC
Entity type:Organization
Organization Name:EMERGACARE NY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MINERVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-965-5040
Mailing Address - Street 1:722 NEPPERHAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703
Mailing Address - Country:US
Mailing Address - Phone:914-965-5040
Mailing Address - Fax:914-965-9776
Practice Address - Street 1:722 NEPPERHAN AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-2312
Practice Address - Country:US
Practice Address - Phone:914-965-5040
Practice Address - Fax:914-965-9776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02339004Medicaid
A1011825OtherOXFORD
NY02339004Medicaid