Provider Demographics
NPI:1902077456
Name:UNITY AMBULETTE CORP.
Entity Type:Organization
Organization Name:UNITY AMBULETTE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-292-6973
Mailing Address - Street 1:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:NY
Mailing Address - Zip Code:12734
Mailing Address - Country:US
Mailing Address - Phone:845-292-6973
Mailing Address - Fax:845-292-9168
Practice Address - Street 1:37 MAIN ST
Practice Address - Street 2:
Practice Address - City:PARKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12768-5009
Practice Address - Country:US
Practice Address - Phone:845-292-6973
Practice Address - Fax:845-292-9168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00883867Medicaid