Healthcare Provider Details

I. General information

NPI: 1962551283
Provider Name (Legal Business Name): ADIRONDACK CENTRAL SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 04/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 FORD ST
BOONVILLE NY
13309-1204
US

IV. Provider business mailing address

110 FORD ST
BOONVILLE NY
13309-1204
US

V. Phone/Fax

Practice location:
  • Phone: 315-942-9208
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: SHARON CIHOCKI
Title or Position: BUSINESS ADMINISTRATOR
Credential:
Phone: 315-942-9208