Provider Demographics
NPI:1700126646
Name:SECAUCUS SCHOOL DISTRICT
Entity Type:Organization
Organization Name:SECAUCUS SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. BA
Authorized Official - Prefix:MS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:YEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-974-2070
Mailing Address - Street 1:PO BOX 1496
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07096-1496
Mailing Address - Country:US
Mailing Address - Phone:201-974-2070
Mailing Address - Fax:201-974-1911
Practice Address - Street 1:20 CENTRE AVE
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-3202
Practice Address - Country:US
Practice Address - Phone:201-974-2070
Practice Address - Fax:201-974-1911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0161853Medicaid