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I haven't done any out of state trips (yet), but another company in town has a contract that brings them to NYC, from Scranton PA, fairly often.
The way I see it, it should go like this (assumed that you are an EMT-P, and out of state):
mind you this is coming from a new EMT-B
911: (insert local 911 speal here)
You (being a EMT-P): This is YourState Medic 1234 from YourCounty. While stopped at ABC rest stop there was a (Cardiac/Epileptic/whatever) emergency and we have started pt care at a BLS level. we are ALS capable and would like to begin ALS care. can you contact local medical command for us?
Now I don't know all the legal aspects of a PA medic in NYC, but the way I see it, know what your medical command DR thinks about the situation, and contact the medical command dr of a nearby hospital to see what they think.
That's assuming that the 911 operator is able to contact a base hospital.