Provider Demographics
NPI:1487937355
Name:HOMMOCKS MIDDLE SCHOOL
Entity type:Organization
Organization Name:HOMMOCKS MIDDLE SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KADY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:914-220-3364
Mailing Address - Street 1:130 HOMMOCKS RD
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-3914
Mailing Address - Country:US
Mailing Address - Phone:914-220-3364
Mailing Address - Fax:
Practice Address - Street 1:130 HOMMOCKS RD
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-3914
Practice Address - Country:US
Practice Address - Phone:914-220-3364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01395326Medicaid