Provider Demographics
NPI:1679630040
Name:FALCONER CENTRAL SCHOOL
Entity Type:Organization
Organization Name:FALCONER CENTRAL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:AGETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-665-6624
Mailing Address - Street 1:2 EAST AVE N
Mailing Address - Street 2:
Mailing Address - City:FALCONER
Mailing Address - State:NY
Mailing Address - Zip Code:14733-1302
Mailing Address - Country:US
Mailing Address - Phone:716-665-6624
Mailing Address - Fax:716-665-9265
Practice Address - Street 1:2 EAST AVE N
Practice Address - Street 2:
Practice Address - City:FALCONER
Practice Address - State:NY
Practice Address - Zip Code:14733-1302
Practice Address - Country:US
Practice Address - Phone:716-665-6624
Practice Address - Fax:716-665-9265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01407134Medicaid