Provider Demographics
NPI:1831361377
Name:ENGLEWOOD BOARD OF EDUCATION
Entity type:Organization
Organization Name:ENGLEWOOD BOARD OF EDUCATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-862-6000
Mailing Address - Street 1:12 TENAFLY RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2206
Mailing Address - Country:US
Mailing Address - Phone:201-862-6000
Mailing Address - Fax:
Practice Address - Street 1:12 TENAFLY RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2206
Practice Address - Country:US
Practice Address - Phone:201-862-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6730400Medicaid