Provider Demographics
NPI:1215081682
Name:TST BOCES
Entity type:Organization
Organization Name:TST BOCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR ACCOUNT CLERK TYPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:NATOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-257-1551
Mailing Address - Street 1:555 WARREN RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1862
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:555 WARREN RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1862
Practice Address - Country:US
Practice Address - Phone:607-257-1551
Practice Address - Fax:607-257-2958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01390454Medicaid