Provider Demographics
NPI:1962726638
Name:MONTCLAIR AMBULANCE UNIT
Entity type:Organization
Organization Name:MONTCLAIR AMBULANCE UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HIRSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-783-7624
Mailing Address - Street 1:PO BOX 868
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-0868
Mailing Address - Country:US
Mailing Address - Phone:856-784-8004
Mailing Address - Fax:856-768-2739
Practice Address - Street 1:95 WALNUT ST
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-4038
Practice Address - Country:US
Practice Address - Phone:973-783-7624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJM07110143416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport