Healthcare Provider Details

I. General information

NPI: 1245384593
Provider Name (Legal Business Name): LYONS CENTRAL SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 05/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CLYDE RD
LYONS NY
14489-9364
US

IV. Provider business mailing address

10 CLYDE RD
LYONS NY
14489-9364
US

V. Phone/Fax

Practice location:
  • Phone: 315-946-2200
  • Fax: 315-946-2205
Mailing address:
  • Phone: 315-946-2200
  • Fax: 315-946-2205

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. MIKE PANGALLO
Title or Position: BUSINESS OFFICIAL
Credential:
Phone: 315-946-2200