Provider Demographics
NPI:1477603280
Name:TOWN OF WEBB UFSD
Entity Type:Organization
Organization Name:TOWN OF WEBB UFSD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CSE SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:S
Authorized Official - Last Name:FETTERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-369-3222
Mailing Address - Street 1:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:OLD FORGE
Mailing Address - State:NY
Mailing Address - Zip Code:13420-0038
Mailing Address - Country:US
Mailing Address - Phone:315-369-3222
Mailing Address - Fax:315-369-6216
Practice Address - Street 1:3002 MAIN STREET
Practice Address - Street 2:
Practice Address - City:OLD FORGE
Practice Address - State:NY
Practice Address - Zip Code:13420-0038
Practice Address - Country:US
Practice Address - Phone:315-369-3222
Practice Address - Fax:315-369-6216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01378945Medicaid