Provider Demographics
NPI:1649312349
Name:PHOENIX CENTRAL SCHOOL DISTRICT
Entity type:Organization
Organization Name:PHOENIX CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SONNACCHIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-695-1512
Mailing Address - Street 1:116 VOLNEY ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:NY
Mailing Address - Zip Code:13135-3103
Mailing Address - Country:US
Mailing Address - Phone:315-695-1512
Mailing Address - Fax:
Practice Address - Street 1:11 ELM ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:NY
Practice Address - Zip Code:13135-1922
Practice Address - Country:US
Practice Address - Phone:315-695-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01383100Medicaid