Provider Demographics
NPI:1275861387
Name:PORT CHESTER-RYE UFSD
Entity Type:Organization
Organization Name:PORT CHESTER-RYE UFSD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR OFFICE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERTELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-934-7926
Mailing Address - Street 1:113 BOWMAN AVE
Mailing Address - Street 2:BOX 113
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-2808
Mailing Address - Country:US
Mailing Address - Phone:914-934-7926
Mailing Address - Fax:
Practice Address - Street 1:113 BOWMAN AVENUE
Practice Address - Street 2:BOX 113
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-2808
Practice Address - Country:US
Practice Address - Phone:914-934-7926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01406968Medicaid