Provider Demographics
NPI:1720143506
Name:WATERFORD-HALFMOON UFSD
Entity Type:Organization
Organization Name:WATERFORD-HALFMOON UFSD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:KLOSSNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-237-0800
Mailing Address - Street 1:125 MIDDLETOWN RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:NY
Mailing Address - Zip Code:12188-1516
Mailing Address - Country:US
Mailing Address - Phone:518-237-0800
Mailing Address - Fax:518-237-7335
Practice Address - Street 1:125 MIDDLETOWN RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:NY
Practice Address - Zip Code:12188-1516
Practice Address - Country:US
Practice Address - Phone:518-237-0800
Practice Address - Fax:518-237-7335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
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
NY01381593Medicaid