Provider Demographics
NPI:1447306378
Name:SHOREHAM-WADING RIVER CENTRAL SCHOOL DISTRICT
Entity type:Organization
Organization Name:SHOREHAM-WADING RIVER CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:PALUMBERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-821-8110
Mailing Address - Street 1:250B ROUTE 25A
Mailing Address - Street 2:
Mailing Address - City:SHOREHAM
Mailing Address - State:NY
Mailing Address - Zip Code:11786-2106
Mailing Address - Country:US
Mailing Address - Phone:631-821-8100
Mailing Address - Fax:631-929-3001
Practice Address - Street 1:250B ROUTE 25A
Practice Address - Street 2:
Practice Address - City:SHOREHAM
Practice Address - State:NY
Practice Address - Zip Code:11786-2106
Practice Address - Country:US
Practice Address - Phone:631-821-8100
Practice Address - Fax:631-929-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01383471Medicaid