Provider Demographics
NPI:1467738088
Name:MEXICO ACADEMY & CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:MEXICO ACADEMY & CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:FARELLA
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:315-963-8400
Mailing Address - Street 1:26 ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:MEXICO
Mailing Address - State:NY
Mailing Address - Zip Code:13114-3010
Mailing Address - Country:US
Mailing Address - Phone:315-963-8400
Mailing Address - Fax:315-963-8992
Practice Address - Street 1:26 ACADEMY ST
Practice Address - Street 2:
Practice Address - City:MEXICO
Practice Address - State:NY
Practice Address - Zip Code:13114-3010
Practice Address - Country:US
Practice Address - Phone:315-963-8400
Practice Address - Fax:315-963-8992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY501989251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)