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General NPI Number Information
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NPI Number | 1588716898
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Entity Type | Organization
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Legal Business Name | MAHOPAC CSD
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 03/03/2015
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Provider Practice Location Address
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Address Line | 179 E LAKE BLVD
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City | MAHOPAC
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State | NY
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Zip | 10541-1601
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Country | US
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Telephone | 845-628-3415
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Fax | 845-628-0261
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Provider Business Mailing Address
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Address Line | 179 E LAKE BLVD
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City | MAHOPAC
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State | NY
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Zip | 10541-1601
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Country | US
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Telephone | 845-628-3415
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Fax | 845-628-0261
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Authorized Official
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Title or Position | ASSISTANT SUPERINTENDENT FOR P.P.S.
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Name | DR. GREG STOWELL
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Credential | D.P.S.
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Telephone | 845-621-0656
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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 |
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License Number State |
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