Provider Demographics
NPI:1053478537
Name:PENFIELD CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:PENFIELD CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SUPERINTENDENT FOR BUSINE
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SANSOUCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-249-5723
Mailing Address - Street 1:2590 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-1543
Mailing Address - Country:US
Mailing Address - Phone:585-249-5700
Mailing Address - Fax:585-248-0725
Practice Address - Street 1:2590 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-1543
Practice Address - Country:US
Practice Address - Phone:585-249-5700
Practice Address - Fax:585-248-0725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01528647Medicaid