Provider Demographics
NPI:1376722181
Name:POMPTON LAKES BOARD OF EDUCATION
Entity Type:Organization
Organization Name:POMPTON LAKES BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL BUSINESS ADMIN/BD. SEC.
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:CIAVAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:CPA,SBA/BS
Authorized Official - Phone:973-835-1553
Mailing Address - Street 1:237 VAN AVE
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-1343
Mailing Address - Country:US
Mailing Address - Phone:973-835-1553
Mailing Address - Fax:973-835-1748
Practice Address - Street 1:237 VAN AVE
Practice Address - Street 2:
Practice Address - City:POMPTON LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07442-1343
Practice Address - Country:US
Practice Address - Phone:973-835-1553
Practice Address - Fax:973-835-1748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6784208Medicaid