Provider Demographics
NPI:1346397429
Name:CLYMER CENTRAL SCHOOL
Entity Type:Organization
Organization Name:CLYMER CENTRAL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOMBARDOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-355-4444
Mailing Address - Street 1:8672 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLYMER
Mailing Address - State:NY
Mailing Address - Zip Code:14724-9713
Mailing Address - Country:US
Mailing Address - Phone:716-355-4444
Mailing Address - Fax:716-355-4467
Practice Address - Street 1:8672 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CLYMER
Practice Address - State:NY
Practice Address - Zip Code:14724-9713
Practice Address - Country:US
Practice Address - Phone:716-355-4444
Practice Address - Fax:716-355-4467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01390418Medicaid