Healthcare Provider Details

I. General information

NPI: 1053680512
Provider Name (Legal Business Name): HIGHLANDFALLSFORTMONTGOMERYCSD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2011
Last Update Date: 12/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21MORGANROAD
FORTMONTGOMERY NY
10922
US

IV. Provider business mailing address

52 MOUNTAIN AVE
HIGHLAND FALLS NY
10928-1303
US

V. Phone/Fax

Practice location:
  • Phone: 845-446-4914
  • Fax:
Mailing address:
  • Phone: 845-446-4761
  • Fax: 845-446-0858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number307270
License Number StateNY

VIII. Authorized Official

Name: MRS. CHRISTINE ARMSTRONG
Title or Position: ADMINISTRATOR PUPIL SERVICES
Credential:
Phone: 845-446-4761