Provider Demographics
NPI:1508922501
Name:BOARD OF EDUCATION
Entity Type:Organization
Organization Name:BOARD OF EDUCATION
Other - Org Name:GREENWICH CENTRAL SCHOOL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-692-9542
Mailing Address - Street 1:10 GRAY AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:NY
Mailing Address - Zip Code:12834
Mailing Address - Country:US
Mailing Address - Phone:518-692-9542
Mailing Address - Fax:518-692-9547
Practice Address - Street 1:10 GRAY AVE
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:NY
Practice Address - Zip Code:12834
Practice Address - Country:US
Practice Address - Phone:518-692-9542
Practice Address - Fax:518-692-9547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01384981Medicaid