Provider Demographics
NPI:1932230281
Name:SANDY CREEK CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:SANDY CREEK CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMBARERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-387-3445
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:SANDY CREEK
Mailing Address - State:NY
Mailing Address - Zip Code:13145-0248
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:124 SALISBURY STREET
Practice Address - Street 2:
Practice Address - City:SANDY CREEK
Practice Address - State:NY
Practice Address - Zip Code:13145-0248
Practice Address - Country:US
Practice Address - Phone:315-387-3445
Practice Address - Fax:315-387-2196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01381539Medicaid