=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275861387
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PORT CHESTER-RYE UFSD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/01/2009
-----------------------------------------------------
Last Update Date | 12/01/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 113 BOWMAN AVENUE BOX 113
-----------------------------------------------------
City | RYE BROOK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10573-2808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-934-7926
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 113 BOWMAN AVE BOX 113
-----------------------------------------------------
City | RYE BROOK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10573-2808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-934-7926
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SENIOR OFFICE ASSISTANT
-----------------------------------------------------
Name | MS. MARIANNE ALBERTELL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 914-934-7926
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------