Healthcare Provider Details

I. General information

NPI: 1881748994
Provider Name (Legal Business Name): MECHANICVILLE CITY SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 04/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 KNISKERN AVE BUSINESS OFFICE
MECHANICVILLE NY
12118-2124
US

IV. Provider business mailing address

25 KNISKERN AVE BUSINESS OFFICE
MECHANICVILLE NY
12118-2124
US

V. Phone/Fax

Practice location:
  • Phone: 518-664-5727
  • Fax: 518-514-2102
Mailing address:
  • Phone: 518-664-5727
  • Fax: 518-514-2102

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: WILLIAM T WOODS
Title or Position: BUSINESS ADMINISTRATOR
Credential:
Phone: 518-664-5727