Provider Demographics
NPI:1952466286
Name:WATERVLIET CITY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:WATERVLIET CITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:S
Authorized Official - Last Name:CAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-629-3201
Mailing Address - Street 1:1245 HILLSIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:WATERVLIET
Mailing Address - State:NY
Mailing Address - Zip Code:12189
Mailing Address - Country:US
Mailing Address - Phone:518-629-3203
Mailing Address - Fax:518-629-3268
Practice Address - Street 1:1245 HILLSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:WATERVLIET
Practice Address - State:NY
Practice Address - Zip Code:12189
Practice Address - Country:US
Practice Address - Phone:518-629-3203
Practice Address - Fax:518-629-3268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01422788Medicaid