Provider Demographics
NPI:1932388246
Name:BOARD OF EDUCATION CITY OF BRIGANTINE
Entity Type:Organization
Organization Name:BOARD OF EDUCATION CITY OF BRIGANTINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PREVITI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-266-7671
Mailing Address - Street 1:301 EAST EVANS BLVD
Mailing Address - Street 2:BRIGANTINE SCHOOL DISTRICT
Mailing Address - City:BRIGANTINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08203
Mailing Address - Country:US
Mailing Address - Phone:609-266-7671
Mailing Address - Fax:
Practice Address - Street 1:301 EAST EVANS BLVD
Practice Address - Street 2:BRIGANTINE SCHOOL DISTRICT
Practice Address - City:BRIGANTINE
Practice Address - State:NJ
Practice Address - Zip Code:08203
Practice Address - Country:US
Practice Address - Phone:609-266-7671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6476201Medicaid