Provider Demographics
NPI:1215094545
Name:MASSENA CENTRAL SCHOOL DISTRICT
Entity type:Organization
Organization Name:MASSENA CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:CROFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-764-3700
Mailing Address - Street 1:84 NIGHTENGALE AVENUE
Mailing Address - Street 2:MASSENA CENTRAL SCHOOL DISTRICT
Mailing Address - City:MASSENA
Mailing Address - State:NY
Mailing Address - Zip Code:13662-1998
Mailing Address - Country:US
Mailing Address - Phone:315-764-3700
Mailing Address - Fax:315-764-3701
Practice Address - Street 1:84 NIGHTENGALE AVENUE
Practice Address - Street 2:MASSENA CENTRAL SCHOOL DISTRICT
Practice Address - City:MASSENA
Practice Address - State:NY
Practice Address - Zip Code:13662-1998
Practice Address - Country:US
Practice Address - Phone:315-764-3700
Practice Address - Fax:315-764-3701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
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
NY01377866Medicaid