Provider Demographics
NPI:1548319718
Name:AVERILL PARK CENTRAL SCHOOL DISTRICT
Entity type:Organization
Organization Name:AVERILL PARK CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:P
Authorized Official - Last Name:MOCCIA
Authorized Official - Suffix:
Authorized Official - Credentials:ED D
Authorized Official - Phone:518-674-7066
Mailing Address - Street 1:8439 MILLER HILL RD # 1
Mailing Address - Street 2:
Mailing Address - City:AVERILL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12018-2608
Mailing Address - Country:US
Mailing Address - Phone:518-674-7066
Mailing Address - Fax:518-674-3802
Practice Address - Street 1:8439 MILLER HILL RD # 1
Practice Address - Street 2:
Practice Address - City:AVERILL PARK
Practice Address - State:NY
Practice Address - Zip Code:12018-2608
Practice Address - Country:US
Practice Address - Phone:518-674-7066
Practice Address - Fax:518-674-3802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
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
NY01379024Medicaid