Provider Demographics
NPI:1740327287
Name:TOWN OF BRUNSWICK GRAFTON CENTRAL SCHOOL DISTRICT 2
Entity type:Organization
Organization Name:TOWN OF BRUNSWICK GRAFTON CENTRAL SCHOOL DISTRICT 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. SUPERINTENDENT FOR BUSINESS
Authorized Official - Prefix:
Authorized Official - First Name:LYN
Authorized Official - Middle Name:
Authorized Official - Last Name:DERWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-279-4600
Mailing Address - Street 1:3992 STATE HIGHWAY 2
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-9022
Mailing Address - Country:US
Mailing Address - Phone:518-279-4600
Mailing Address - Fax:518-279-1918
Practice Address - Street 1:3992 STATE HIGHWAY 2
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-9022
Practice Address - Country:US
Practice Address - Phone:518-279-4600
Practice Address - Fax:518-279-1918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01442415Medicaid