Provider Demographics
NPI:1679510580
Name:SHIKELLAMY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:SHIKELLAMY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:SINOPOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-286-3708
Mailing Address - Street 1:200 ISLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17801-1028
Mailing Address - Country:US
Mailing Address - Phone:570-286-3779
Mailing Address - Fax:570-286-3776
Practice Address - Street 1:200 ISLAND BLVD
Practice Address - Street 2:
Practice Address - City:SUNBURY
Practice Address - State:PA
Practice Address - Zip Code:17801-1028
Practice Address - Country:US
Practice Address - Phone:570-286-3779
Practice Address - Fax:570-286-3776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016256600001Medicaid