Provider Demographics
NPI:1629123484
Name:MONTICELLO CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:MONTICELLO CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PUPIL PERSONNEL SERVICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DURYEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-794-7700
Mailing Address - Street 1:37 BREAKEY AVENUE
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701
Mailing Address - Country:US
Mailing Address - Phone:845-794-7700
Mailing Address - Fax:845-794-0250
Practice Address - Street 1:148 WOOD AVE
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-2329
Practice Address - Country:US
Practice Address - Phone:845-794-0128
Practice Address - Fax:845-794-0250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01477141Medicaid