Provider Demographics
NPI:1194054510
Name:REMSENBURG-SPEONK UFSD
Entity type:Organization
Organization Name:REMSENBURG-SPEONK UFSD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL EDUCATION DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:ACHILICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-325-0203
Mailing Address - Street 1:PO BOX 900
Mailing Address - Street 2:11 MILL ROAD
Mailing Address - City:REMSENBURG
Mailing Address - State:NY
Mailing Address - Zip Code:11960-0900
Mailing Address - Country:US
Mailing Address - Phone:631-325-0203
Mailing Address - Fax:631-325-8439
Practice Address - Street 1:11 MILL ROAD
Practice Address - Street 2:
Practice Address - City:REMSENBURG
Practice Address - State:NY
Practice Address - Zip Code:11960-0900
Practice Address - Country:US
Practice Address - Phone:631-325-0203
Practice Address - Fax:631-325-8439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01378812Medicaid