Provider Demographics
NPI:1609913672
Name:MILLBROOK CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:MILLBROOK CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SUPERINTENDENT FOR PPS
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:AFFIGNE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:845-677-4200
Mailing Address - Street 1:PO BOX AA
Mailing Address - Street 2:
Mailing Address - City:MILLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:12545-0127
Mailing Address - Country:US
Mailing Address - Phone:845-677-4200
Mailing Address - Fax:845-677-4206
Practice Address - Street 1:43 ALDEN PLACE
Practice Address - Street 2:
Practice Address - City:MILLBROOK
Practice Address - State:NY
Practice Address - Zip Code:12545-0127
Practice Address - Country:US
Practice Address - Phone:845-677-4215
Practice Address - Fax:845-677-4206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01377893Medicaid