Provider Demographics
NPI:1871640854
Name:GREENPORT UNION FREE SCHOOL DISTRICT
Entity Type:Organization
Organization Name:GREENPORT UNION FREE SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPED
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:TSAVERAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-477-1950
Mailing Address - Street 1:720 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:GREENPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11944-1500
Mailing Address - Country:US
Mailing Address - Phone:631-477-1950
Mailing Address - Fax:631-477-2164
Practice Address - Street 1:720 FRONT ST
Practice Address - Street 2:
Practice Address - City:GREENPORT
Practice Address - State:NY
Practice Address - Zip Code:11944-1500
Practice Address - Country:US
Practice Address - Phone:631-477-1950
Practice Address - Fax:631-477-2164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01382214Medicaid