Provider Demographics
NPI:1760696512
Name:ELIZABETH PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:ELIZABETH PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIARELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:908-436-5201
Mailing Address - Street 1:27 PRINCE STREET
Mailing Address - Street 2:2ND. FLOOR
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208
Mailing Address - Country:US
Mailing Address - Phone:908-436-5200
Mailing Address - Fax:908-436-5237
Practice Address - Street 1:27 PRINCE STREET
Practice Address - Street 2:2ND. FLOOR
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208
Practice Address - Country:US
Practice Address - Phone:908-436-5200
Practice Address - Fax:908-436-5237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
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
NJ6543804Medicaid