Provider Demographics
NPI:1376671453
Name:WEST HAVEN BOARD OF EDUCATION
Entity Type:Organization
Organization Name:WEST HAVEN BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID CLERK
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PANZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-931-4790
Mailing Address - Street 1:25 OGDEN ST
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-1839
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25 OGDEN ST
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-1839
Practice Address - Country:US
Practice Address - Phone:203-931-4790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)