Provider Demographics
NPI:1225185317
Name:ITHACA CITY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:ITHACA CITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:PASTEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-274-2101
Mailing Address - Street 1:PO BOX 549
Mailing Address - Street 2:400 LAKE STREET
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14851-5549
Mailing Address - Country:US
Mailing Address - Phone:607-274-2101
Mailing Address - Fax:607-274-2318
Practice Address - Street 1:400 LAKE ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-2132
Practice Address - Country:US
Practice Address - Phone:607-274-2101
Practice Address - Fax:607-274-2318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
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
NY01445490Medicaid