Provider Demographics
NPI:1437201977
Name:FONDA-FULTONVILLE CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:FONDA-FULTONVILLE CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CIACCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-853-3189
Mailing Address - Street 1:PO BOX 1501
Mailing Address - Street 2:112 OLD JOHNSTOWN ROAD
Mailing Address - City:FONDA
Mailing Address - State:NY
Mailing Address - Zip Code:12068-1501
Mailing Address - Country:US
Mailing Address - Phone:518-853-4415
Mailing Address - Fax:518-853-4461
Practice Address - Street 1:112 OLD JOHNSTOWN RD
Practice Address - Street 2:
Practice Address - City:FONDA
Practice Address - State:NY
Practice Address - Zip Code:12068-5410
Practice Address - Country:US
Practice Address - Phone:518-853-4415
Practice Address - Fax:518-853-4461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01377531Medicaid