Provider Demographics
NPI:1679610943
Name:SPENCER-VAN ETTEN CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:SPENCER-VAN ETTEN CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCHOONMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-589-7100
Mailing Address - Street 1:PO BOX 307
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:NY
Mailing Address - Zip Code:14883-0307
Mailing Address - Country:US
Mailing Address - Phone:607-589-7100
Mailing Address - Fax:607-589-3010
Practice Address - Street 1:16 DARTTS CROSS ROAD
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:NY
Practice Address - Zip Code:14883-0307
Practice Address - Country:US
Practice Address - Phone:607-589-7100
Practice Address - Fax:607-589-3010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01445481Medicaid