=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538594718
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RYE COUNTRY DAY SCHOOL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/06/2013
-----------------------------------------------------
Last Update Date | 09/06/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CEDAR STREET
-----------------------------------------------------
City | RYE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10580
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-967-1417
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 26 TOP OF THE RDG
-----------------------------------------------------
City | MAMARONECK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10543-1734
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-381-3296
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | HEAD MASTER
-----------------------------------------------------
Name | SCOTT A NELSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 914-967-1417
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QS1000X
-----------------------------------------------------
Taxonomy Name | Student Health Clinic/Center
-----------------------------------------------------
License Number | 000003
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------