Provider Demographics
NPI:1568702348
Name:SUMMIT BOARD OF EDUCATION
Entity Type:Organization
Organization Name:SUMMIT BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:PEPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-273-3025
Mailing Address - Street 1:14 BEEKMAN TERRACE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901
Mailing Address - Country:US
Mailing Address - Phone:908-273-3025
Mailing Address - Fax:908-273-3656
Practice Address - Street 1:14 BEEKMAN TERRACE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901
Practice Address - Country:US
Practice Address - Phone:908-273-3025
Practice Address - Fax:908-273-3656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0184241Medicaid