Healthcare Provider Details

I. General information

NPI: 1952679946
Provider Name (Legal Business Name): OGDENSBURG CITY SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2011
Last Update Date: 12/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 STATE ST
OGDENSBURG NY
13669-3352
US

IV. Provider business mailing address

1100 STATE ST
OGDENSBURG NY
13669-3352
US

V. Phone/Fax

Practice location:
  • Phone: 315-393-0900
  • Fax: 315-394-7132
Mailing address:
  • Phone: 315-393-0900
  • Fax: 315-394-7132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number253910-1
License Number StateNY

VIII. Authorized Official

Name: MR. TIMOTHY M VERNSEY
Title or Position: SUPERINTENDENT
Credential:
Phone: 315-393-0900