Provider Demographics
NPI:1396892816
Name:HARTFORD CSD
Entity type:Organization
Organization Name:HARTFORD CSD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOL
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-632-5931
Mailing Address - Street 1:PO BOX 79
Mailing Address - Street 2:4704 STATE ROUTE 149
Mailing Address - City:HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:12838-0079
Mailing Address - Country:US
Mailing Address - Phone:518-632-5222
Mailing Address - Fax:518-632-5231
Practice Address - Street 1:4704 STATE RT 149
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:12838
Practice Address - Country:US
Practice Address - Phone:518-632-5222
Practice Address - Fax:518-632-5231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01383682Medicaid