Provider Demographics
NPI:1619034196
Name:S KORTRIGHT CENTRAL SCHOOL
Entity Type:Organization
Organization Name:S KORTRIGHT CENTRAL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:ISIDOR
Authorized Official - Last Name:KANAREK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-538-9111
Mailing Address - Street 1:58200 STATE HIGHWAY 10
Mailing Address - Street 2:P.O. BOX 113
Mailing Address - City:SOUTH KORTRIGHT
Mailing Address - State:NY
Mailing Address - Zip Code:13842-0113
Mailing Address - Country:US
Mailing Address - Phone:607-538-9111
Mailing Address - Fax:607-538-9205
Practice Address - Street 1:58200 STATE HIGHWAY 10
Practice Address - Street 2:
Practice Address - City:SOUTH KORTRIGHT
Practice Address - State:NY
Practice Address - Zip Code:13842-0113
Practice Address - Country:US
Practice Address - Phone:607-538-9111
Practice Address - Fax:607-538-9205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01367615Medicaid