Healthcare Provider Details

I. General information

NPI: 1245381268
Provider Name (Legal Business Name): CANAJOHARIE CENTRAL SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 SCHOLASTIC WAY
CANAJOHARIE NY
13317-3924
US

IV. Provider business mailing address

136 SCHOLASTIC WAY
CANAJOHARIE NY
13317-3924
US

V. Phone/Fax

Practice location:
  • Phone: 518-673-6317
  • Fax: 518-673-3887
Mailing address:
  • Phone: 518-673-6317
  • Fax: 518-673-3887

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: MR. RICHARD G. ROSE
Title or Position: SCHOOL SUPERINTENDENT
Credential:
Phone: 518-673-6302