Healthcare Provider Details

I. General information

NPI: 1912034406
Provider Name (Legal Business Name): DOLGEVILLE CENTRAL SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 03/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 SLAWSON ST
DOLGEVILLE NY
13329-1238
US

IV. Provider business mailing address

38 SLAWSON ST
DOLGEVILLE NY
13329-1238
US

V. Phone/Fax

Practice location:
  • Phone: 315-429-3155
  • Fax: 315-429-8473
Mailing address:
  • Phone: 315-429-3155
  • Fax: 315-429-8473

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. JOHN J MCKEOWN
Title or Position: BUSINESS ADMINISTRATOR
Credential:
Phone: 315-429-3155