Provider Demographics
NPI:1669504973
Name:CITY OF WORCESTER
Entity Type:Organization
Organization Name:CITY OF WORCESTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CARADONIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-799-3115
Mailing Address - Street 1:20 IRVING ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-2467
Mailing Address - Country:US
Mailing Address - Phone:508-799-3311
Mailing Address - Fax:
Practice Address - Street 1:20 IRVING ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-2467
Practice Address - Country:US
Practice Address - Phone:508-799-3311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1950622Medicaid