Provider Demographics
NPI:1780926956
Name:COMMACK SCHOOL DISTRICT
Entity type:Organization
Organization Name:COMMACK SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MORELLO
Authorized Official - Suffix:
Authorized Official - Credentials:RNC
Authorized Official - Phone:631-858-3687
Mailing Address - Street 1:15 NEW HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11754
Mailing Address - Country:US
Mailing Address - Phone:631-858-3687
Mailing Address - Fax:631-858-3698
Practice Address - Street 1:15 NEW HIGHWAY
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725
Practice Address - Country:US
Practice Address - Phone:631-858-3687
Practice Address - Fax:631-858-3698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY40807-1251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)