Provider Demographics
NPI:1144377649
Name:LIBERTY CENTRAL SCHOOL
Entity Type:Organization
Organization Name:LIBERTY CENTRAL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. SUPT. FOR BUSINESS
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VANYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-292-6171
Mailing Address - Street 1:115 BUCKLEY ST
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:NY
Mailing Address - Zip Code:12754-1601
Mailing Address - Country:US
Mailing Address - Phone:845-292-6171
Mailing Address - Fax:
Practice Address - Street 1:115 BUCKLEY ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:NY
Practice Address - Zip Code:12754-1601
Practice Address - Country:US
Practice Address - Phone:845-292-6171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01369277Medicaid