Provider Demographics
NPI:1619092335
Name:WILSON AREA SD
Entity Type:Organization
Organization Name:WILSON AREA SD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF STUDENT SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:D
Authorized Official - Last Name:NASATY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-373-6000
Mailing Address - Street 1:2040 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-3890
Mailing Address - Country:US
Mailing Address - Phone:484-373-6000
Mailing Address - Fax:810-258-6421
Practice Address - Street 1:2040 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3890
Practice Address - Country:US
Practice Address - Phone:484-373-6000
Practice Address - Fax:810-258-6421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019223600001Medicaid