Provider Demographics
NPI:1780941401
Name:EAST WILLISTON SCHOOL DISTRICT
Entity type:Organization
Organization Name:EAST WILLISTON SCHOOL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SCHOOL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLAN-MCNAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:516-333-6191
Mailing Address - Street 1:11 BACON RD
Mailing Address - Street 2:
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568-1502
Mailing Address - Country:US
Mailing Address - Phone:516-333-6191
Mailing Address - Fax:
Practice Address - Street 1:11 BACON RD
Practice Address - Street 2:
Practice Address - City:OLD WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11568-1502
Practice Address - Country:US
Practice Address - Phone:516-333-6191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)