Provider Demographics
NPI:1346210135
Name:AMERICAN SCHOOL FOR THE DEAF
Entity Type:Organization
Organization Name:AMERICAN SCHOOL FOR THE DEAF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-570-1816
Mailing Address - Street 1:AUDIOLOGY DEPARTMENT
Mailing Address - Street 2:139 NORTH MAIN STREET
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107
Mailing Address - Country:US
Mailing Address - Phone:860-570-1887
Mailing Address - Fax:860-570-2271
Practice Address - Street 1:139 N MAIN ST
Practice Address - Street 2:AUDIOLOGY DEPARTMENT
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-1264
Practice Address - Country:US
Practice Address - Phone:860-570-1887
Practice Address - Fax:860-570-2271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed ChildrenGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT18775677205Medicare ID - Type Unspecified