Provider Demographics
NPI:1942252002
Name:HAZLETON AREA SCHOOL DISTRICT
Entity Type:Organization
Organization Name:HAZLETON AREA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:RYBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-459-3111
Mailing Address - Street 1:1515 W 23RD ST
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18202-1647
Mailing Address - Country:US
Mailing Address - Phone:570-459-3111
Mailing Address - Fax:570-459-3211
Practice Address - Street 1:1515 W 23RD ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18202-1647
Practice Address - Country:US
Practice Address - Phone:570-459-3111
Practice Address - Fax:570-459-3211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012945400003Medicaid