Provider Demographics
NPI:1477606994
Name:WILSON CENTRAL SCHOOLS
Entity type:Organization
Organization Name:WILSON CENTRAL SCHOOLS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL ED.
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:CANCILLA JR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-751-9341
Mailing Address - Street 1:412 LAKE ST.
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NY
Mailing Address - Zip Code:14172
Mailing Address - Country:US
Mailing Address - Phone:716-751-9341
Mailing Address - Fax:716-751-0008
Practice Address - Street 1:412 LAKE ST.
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NY
Practice Address - Zip Code:14172
Practice Address - Country:US
Practice Address - Phone:716-751-9341
Practice Address - Fax:716-751-0008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01382058Medicaid