Provider Demographics
NPI:1770509226
Name:SOUTHERN CAYUGA INSTANT AID, INC.
Entity type:Organization
Organization Name:SOUTHERN CAYUGA INSTANT AID, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DICKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-364-9500
Mailing Address - Street 1:PO BOX 535
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-0535
Mailing Address - Country:US
Mailing Address - Phone:315-635-1789
Mailing Address - Fax:315-635-3289
Practice Address - Street 1:2530 RT 34B
Practice Address - Street 2:
Practice Address - City:POPLAR RIDGE
Practice Address - State:NY
Practice Address - Zip Code:13026
Practice Address - Country:US
Practice Address - Phone:315-364-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10926341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
220297500OtherUS DEPT OF LABOR - OWCP
9712190OtherGHI
NY02052624Medicaid
4124189OtherMVP
NY02052624Medicaid