Provider Demographics
NPI:1477732246
Name:SCHOOL DISTRICT OF NEW LONDON
Entity Type:Organization
Organization Name:SCHOOL DISTRICT OF NEW LONDON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-982-8530
Mailing Address - Street 1:901 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:WI
Mailing Address - Zip Code:54961-1653
Mailing Address - Country:US
Mailing Address - Phone:920-982-8530
Mailing Address - Fax:920-982-8551
Practice Address - Street 1:901 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:WI
Practice Address - Zip Code:54961-1653
Practice Address - Country:US
Practice Address - Phone:920-982-8530
Practice Address - Fax:920-982-8551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44210400Medicaid