Provider Demographics
NPI:1740521673
Name:GATEWAY REGIONAL HIGH SCHOOL
Entity type:Organization
Organization Name:GATEWAY REGIONAL HIGH SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONTREVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-848-8203
Mailing Address - Street 1:775 TANYARD RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-3633
Mailing Address - Country:US
Mailing Address - Phone:856-848-8200
Mailing Address - Fax:856-251-9813
Practice Address - Street 1:775 TANYARD RD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-3633
Practice Address - Country:US
Practice Address - Phone:856-848-8200
Practice Address - Fax:856-251-9813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)