Provider Demographics
NPI:1619018827
Name:FABIUS-POMPEY CENTRAL SCHOOL
Entity Type:Organization
Organization Name:FABIUS-POMPEY CENTRAL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-683-5460
Mailing Address - Street 1:1211 MILL ST
Mailing Address - Street 2:
Mailing Address - City:FABIUS
Mailing Address - State:NY
Mailing Address - Zip Code:13063-8718
Mailing Address - Country:US
Mailing Address - Phone:315-683-5460
Mailing Address - Fax:315-683-5569
Practice Address - Street 1:1211 MILL ST
Practice Address - Street 2:
Practice Address - City:FABIUS
Practice Address - State:NY
Practice Address - Zip Code:13063-8718
Practice Address - Country:US
Practice Address - Phone:315-683-5460
Practice Address - Fax:315-683-5569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01394476Medicaid