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General NPI Number Information
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NPI Number | 1265729347
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Entity Type | Organization
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Legal Business Name | EAST SYRACUSE MINOA CSD
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Dates
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Enumeration Date | 07/08/2011
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 407 FREMONT RD
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City | EAST SYRACUSE
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State | NY
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Zip | 13057-2696
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Country | US
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Telephone | 315-434-3002
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Fax |
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Provider Business Mailing Address
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Address Line | 407 FREMONT RD
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City | EAST SYRACUSE
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State | NY
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Zip | 13057-2696
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Country | US
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Telephone | 315-434-3002
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SHEILA TUFANKJIAN
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Credential |
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Telephone | 315-434-3002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 011848-1
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License Number State | NY
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