Provider Demographics
NPI:1275688731
Name:MADRID-WADDINGTON CENTRAL SCHOOL
Entity Type:Organization
Organization Name:MADRID-WADDINGTON CENTRAL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT CIO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRYDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-322-5746
Mailing Address - Street 1:PO BOX 67
Mailing Address - Street 2:2582 STATE HIGHWAY 345
Mailing Address - City:MADRID
Mailing Address - State:NY
Mailing Address - Zip Code:13660-0067
Mailing Address - Country:US
Mailing Address - Phone:315-322-5746
Mailing Address - Fax:315-322-5861
Practice Address - Street 1:2582 STATE HIGHWAY 345
Practice Address - Street 2:
Practice Address - City:MADRID
Practice Address - State:NY
Practice Address - Zip Code:13660-3170
Practice Address - Country:US
Practice Address - Phone:315-322-5746
Practice Address - Fax:315-322-5861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
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
NY01403007Medicaid