Provider Demographics
NPI:1457627168
Name:DEPT OF ED
Entity Type:Organization
Organization Name:DEPT OF ED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELISABETH
Authorized Official - Middle Name:GRETHE
Authorized Official - Last Name:NEHMEH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:718-748-9568
Mailing Address - Street 1:211 72ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-2102
Mailing Address - Country:US
Mailing Address - Phone:718-748-9568
Mailing Address - Fax:718-833-3304
Practice Address - Street 1:211 72ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-2102
Practice Address - Country:US
Practice Address - Phone:718-748-9568
Practice Address - Fax:718-833-3304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3677823140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY367782Medicaid