Provider Demographics
NPI:1477681419
Name:EAST ISLIP SCHOOL DISTRICT
Entity Type:Organization
Organization Name:EAST ISLIP SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. TO THE SUPT. FOR STUDENT SUPP
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:531-224-2060
Mailing Address - Street 1:1 CRAIG B GARIEPY AVE
Mailing Address - Street 2:
Mailing Address - City:ISLIP TERRACE
Mailing Address - State:NY
Mailing Address - Zip Code:11752-2820
Mailing Address - Country:US
Mailing Address - Phone:631-224-2060
Mailing Address - Fax:631-581-4071
Practice Address - Street 1:1 CRAIG B GARIEPY AVE
Practice Address - Street 2:
Practice Address - City:ISLIP TERRACE
Practice Address - State:NY
Practice Address - Zip Code:11752-2820
Practice Address - Country:US
Practice Address - Phone:631-224-2060
Practice Address - Fax:631-581-4071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01419378Medicaid