Provider Demographics
NPI:1336299742
Name:TOWN OF QUEENSBURY UNION FREE SCHOOL DISTRICT 2
Entity Type:Organization
Organization Name:TOWN OF QUEENSBURY UNION FREE SCHOOL DISTRICT 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SUPERINTENDENT FOR BUSINE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:DESANTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-824-5603
Mailing Address - Street 1:429 AVIATION ROAD
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804
Mailing Address - Country:US
Mailing Address - Phone:518-824-5603
Mailing Address - Fax:
Practice Address - Street 1:429 AVIATION ROAD
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804
Practice Address - Country:US
Practice Address - Phone:518-824-5603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01381584Medicaid