Provider Demographics
NPI:1174677322
Name:ELMIRA HEIGHTS CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:ELMIRA HEIGHTS CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDANT OF SCHOOLS
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY BETH
Authorized Official - Middle Name:ROSALIE
Authorized Official - Last Name:FIORE
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MAT, CAS
Authorized Official - Phone:607-734-7114
Mailing Address - Street 1:2083 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:ELMIRA HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:14903-1652
Mailing Address - Country:US
Mailing Address - Phone:607-734-7114
Mailing Address - Fax:
Practice Address - Street 1:1083 COLLEGE AVENUE
Practice Address - Street 2:
Practice Address - City:ELMIRA HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:14903-1549
Practice Address - Country:US
Practice Address - Phone:607-734-7114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01434440Medicaid