Provider Demographics
NPI:1881748994
Name:MECHANICVILLE CITY SCHOOL DISTRICT
Entity type:Organization
Organization Name:MECHANICVILLE CITY SCHOOL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-664-5727
Mailing Address - Street 1:25 KNISKERN AVE
Mailing Address - Street 2:BUSINESS OFFICE
Mailing Address - City:MECHANICVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12118-2124
Mailing Address - Country:US
Mailing Address - Phone:518-664-5727
Mailing Address - Fax:518-514-2102
Practice Address - Street 1:25 KNISKERN AVE
Practice Address - Street 2:BUSINESS OFFICE
Practice Address - City:MECHANICVILLE
Practice Address - State:NY
Practice Address - Zip Code:12118-2124
Practice Address - Country:US
Practice Address - Phone:518-664-5727
Practice Address - Fax:518-514-2102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01379937Medicaid