Provider Demographics
NPI:1831604529
Name:MADISON BOARD OF EDUCATION
Entity type:Organization
Organization Name:MADISON BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT FINANCE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:KUSZPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-245-5607
Mailing Address - Street 1:10 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-2562
Mailing Address - Country:US
Mailing Address - Phone:203-245-6300
Mailing Address - Fax:
Practice Address - Street 1:10 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-2562
Practice Address - Country:US
Practice Address - Phone:203-245-6300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-05
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004097342Medicaid