Provider Demographics
NPI:1114296522
Name:TONAWANDA CITY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:TONAWANDA CITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL WALTER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WALTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:716-694-7678
Mailing Address - Street 1:600 FLETCHER ST
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-3616
Mailing Address - Country:US
Mailing Address - Phone:716-694-7670
Mailing Address - Fax:716-743-8839
Practice Address - Street 1:600 FLETCHER ST
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-3616
Practice Address - Country:US
Practice Address - Phone:716-694-7670
Practice Address - Fax:716-743-8839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03164685Medicaid