=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538211057
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EAST SYRACUSE MINOA SCHOOL DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/17/2007
-----------------------------------------------------
Last Update Date | 05/11/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 407 FREMONT RD
-----------------------------------------------------
City | EAST SYRACUSE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13057-2696
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-656-7262
-----------------------------------------------------
Fax | 315-656-7264
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 407 FREMONT RD
-----------------------------------------------------
City | EAST SYRACUSE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13057-2696
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXEC DIR OF SCHOOL BUSINESS ADMIN
-----------------------------------------------------
Name | MS. SHEILA TUFANKJIAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 315-656-7262
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------