1508922501 NPI number — BOARD OF EDUCATION

Table of content: (NPI 1508922501)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508922501 NPI number — BOARD OF EDUCATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BOARD OF EDUCATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508922501
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/23/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 GRAY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENWICH
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12834
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-692-9542
Provider Business Mailing Address Fax Number:
518-692-9547

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 GRAY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENWICH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12834
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-692-9542
Provider Business Practice Location Address Fax Number:
518-692-9547
Provider Enumeration Date:
12/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FISH
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
SUPERINTENDENT
Authorized Official Telephone Number:
518-692-9542

Provider Taxonomy Codes

  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01384981 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com