Provider Demographics
NPI:1033264692
Name:GREEN ISLAND UNION FREE SCHOOL DISTRICT
Entity Type:Organization
Organization Name:GREEN ISLAND UNION FREE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-273-1422
Mailing Address - Street 1:171 HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:GREEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12183-1212
Mailing Address - Country:US
Mailing Address - Phone:518-273-1422
Mailing Address - Fax:518-270-0818
Practice Address - Street 1:171 HUDSON AVE
Practice Address - Street 2:
Practice Address - City:GREEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:12183-1212
Practice Address - Country:US
Practice Address - Phone:518-273-1422
Practice Address - Fax:518-270-0818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01412179Medicaid