Provider Demographics
NPI:1861549115
Name:SOUTHERN CAYUGA CENTRAL SCHOOL DISTRICT
Entity type:Organization
Organization Name:SOUTHERN CAYUGA CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:M
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-364-7211
Mailing Address - Street 1:2384 STATE ROUTE 34B
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:13026-9743
Mailing Address - Country:US
Mailing Address - Phone:315-364-7211
Mailing Address - Fax:315-364-7863
Practice Address - Street 1:2384 STATE ROUTE 34B
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:NY
Practice Address - Zip Code:13026-9743
Practice Address - Country:US
Practice Address - Phone:315-364-7211
Practice Address - Fax:315-364-7863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01383146Medicaid