Healthcare Provider Details

I. General information

NPI: 1497025373
Provider Name (Legal Business Name): EAST RAMAPO CENTRAL SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2012
Last Update Date: 01/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 VIOLA RD
SPRING VALLEY NY
10977-2035
US

IV. Provider business mailing address

105 S MADISON AVE
SPRING VALLEY NY
10977-5474
US

V. Phone/Fax

Practice location:
  • Phone: 845-577-6110
  • Fax: 845-577-6199
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number311960-1
License Number StateNY

VIII. Authorized Official

Name: ELIE WIZMAN
Title or Position: ASSISTANT SUPERINTENDENT
Credential:
Phone: 845-577-6031