Provider Demographics
NPI:1609159391
Name:MAMARONECK UNION FREE SCHOOL DISTRICT
Entity Type:Organization
Organization Name:MAMARONECK UNION FREE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPY COORDINATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURETTE
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:914-329-1965
Mailing Address - Street 1:1000 W BOSTON POST RD
Mailing Address - Street 2:STUDENT SUPPORT OFFICE
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3328
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 W BOSTON POST RD
Practice Address - Street 2:STUDENT SUPPORT OFFICE
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-3328
Practice Address - Country:US
Practice Address - Phone:914-329-1965
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01395326Medicaid