Provider Demographics
NPI:1164632485
Name:WOOD-RIDGE BOARD OF EDUCATION
Entity Type:Organization
Organization Name:WOOD-RIDGE BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHILD STUDY TEAM COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:RECCHIONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-939-1885
Mailing Address - Street 1:540 WINDSOR RD
Mailing Address - Street 2:
Mailing Address - City:WOOD RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07075-1309
Mailing Address - Country:US
Mailing Address - Phone:201-939-1885
Mailing Address - Fax:201-933-2330
Practice Address - Street 1:540 WINDSOR RD
Practice Address - Street 2:
Practice Address - City:WOOD RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07075-1309
Practice Address - Country:US
Practice Address - Phone:201-939-1885
Practice Address - Fax:201-933-2330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7355301Medicaid