Provider Demographics
NPI:1386708279
Name:WATKINS GLEN CENTRAL SCHOOL DISTRICT
Entity type:Organization
Organization Name:WATKINS GLEN CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SEDLACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-535-3219
Mailing Address - Street 1:303 12TH ST
Mailing Address - Street 2:
Mailing Address - City:WATKINS GLEN
Mailing Address - State:NY
Mailing Address - Zip Code:14891-1627
Mailing Address - Country:US
Mailing Address - Phone:607-535-3219
Mailing Address - Fax:607-535-4629
Practice Address - Street 1:303 12TH ST
Practice Address - Street 2:
Practice Address - City:WATKINS GLEN
Practice Address - State:NY
Practice Address - Zip Code:14891-1627
Practice Address - Country:US
Practice Address - Phone:607-535-3219
Practice Address - Fax:607-535-4629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
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
NY01452437Medicaid