Provider Demographics
NPI:1770129975
Name:ESSEX REGIONAL EDUCATIONAL SERVICES COMMISSION
Entity type:Organization
Organization Name:ESSEX REGIONAL EDUCATIONAL SERVICES COMMISSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:973-405-6262
Mailing Address - Street 1:333 FAIRFIELD RD.
Mailing Address - Street 2:ATTN: AMY WOODS
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004
Mailing Address - Country:US
Mailing Address - Phone:973-405-6262
Mailing Address - Fax:
Practice Address - Street 1:520 POMPTON AVENUE
Practice Address - Street 2:ATTN: AMY WOODS
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009
Practice Address - Country:US
Practice Address - Phone:973-239-0125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ESSEX REGIONAL EDUCATIONAL SERVICES COMMISSION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Single Specialty