Healthcare Provider Details

I. General information

NPI: 1275688731
Provider Name (Legal Business Name): MADRID-WADDINGTON CENTRAL SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2582 STATE HIGHWAY 345
MADRID NY
13660-3170
US

IV. Provider business mailing address

PO BOX 67 2582 STATE HIGHWAY 345
MADRID NY
13660-0067
US

V. Phone/Fax

Practice location:
  • Phone: 315-322-5746
  • Fax: 315-322-5861
Mailing address:
  • Phone: 315-322-5746
  • Fax: 315-322-5861

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. DIANA CRYDERMAN
Title or Position: DISTRICT CIO
Credential:
Phone: 315-322-5746