MEDICARE: AUBURN ENLARGED CITY SCHOOL DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency	450209	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457622128
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUBURN ENLARGED CITY SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	2 N HERMAN AVE
Second Line	:
City	:	AUBURN
State	:	NY
Zip	:	13021-2945
Country	:	US
Telephone Number	:	315-255-8686
Fax Number	:	315-255-8693

Provider Business Practice Location Address
First Line	:	2 N HERMAN AVE
Second Line	:
City	:	AUBURN
State	:	NY
Zip	:	13021-2945
Country	:	US
Telephone Number	:	315-255-8686
Fax Number	:	315-255-8693

Authorized Official
Title or Position	:	DIRECTOR OF SPECIAL EDUCATION
Name	:	MRS. LAURA OWEN
Credential	:
Telephone Number	:	315-255-8811

Provider Enumeration Date	:	01/26/2012
Last Update Date	:	01/26/2012

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