Healthcare Provider Details

I. General information

NPI: 1255469052
Provider Name (Legal Business Name): LAFAYETTE CENTRAL SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5957 ROUTE 20 WEST
LAFAYETTE NY
13084
US

IV. Provider business mailing address

5957 ROUTE 20 WEST
LAFAYETTE NY
13084
US

V. Phone/Fax

Practice location:
  • Phone: 315-677-3152
  • 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: MRS. JENNIFER BLOSSEY
Title or Position: DIRECTOR OF SPECIAL EDUCATION
Credential: SAS
Phone: 315-677-3152