Provider Demographics
NPI:1538210687
Name:FARMINGDALE PUBLIC SCHOOLS
Entity type:Organization
Organization Name:FARMINGDALE PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLERK TYPIST
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-752-6595
Mailing Address - Street 1:50 VAN COTT AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-3743
Mailing Address - Country:US
Mailing Address - Phone:516-752-6595
Mailing Address - Fax:
Practice Address - Street 1:50 VAN COTT AVE
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-3743
Practice Address - Country:US
Practice Address - Phone:516-752-6595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
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
NY01435749Medicaid