Provider Demographics
NPI:1326186677
Name:SYOSSET CENTRAL SD
Entity Type:Organization
Organization Name:SYOSSET CENTRAL SD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST SUPT FOR BUSINESS OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:EISERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-364-5651
Mailing Address - Street 1:PO BOX 9029
Mailing Address - Street 2:99 PELL LANE
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791
Mailing Address - Country:US
Mailing Address - Phone:516-364-5600
Mailing Address - Fax:516-921-5616
Practice Address - Street 1:99 PELL LANE
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791
Practice Address - Country:US
Practice Address - Phone:516-364-5600
Practice Address - Fax:516-921-5616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
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
NY01411590Medicaid