Provider Demographics
NPI:1548319668
Name:PORT WASHINGTON UNION FREE SCHOOL DISTRICT
Entity type:Organization
Organization Name:PORT WASHINGTON UNION FREE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. SUPERINTENDENT FOR BUSINESS
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-767-5011
Mailing Address - Street 1:100 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-3719
Mailing Address - Country:US
Mailing Address - Phone:516-767-5011
Mailing Address - Fax:516-767-4919
Practice Address - Street 1:100 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-3719
Practice Address - Country:US
Practice Address - Phone:516-767-5011
Practice Address - Fax:516-767-4919
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PORT WASHINGTON UNION FREE SCHOOL DICTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-09
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01380083Medicaid