MEDICARE: DEPARTMENT OF EDUCATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)	482233-1	NY

General Provider Information

NPI Number	:	1568738607
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEPARTMENT OF EDUCATION

Provider Business Mailing Address
First Line	:	2904 EASTCHESTER RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-3342
Country	:	US
Telephone Number	:	718-320-1197
Fax Number	:

Provider Business Practice Location Address
First Line	:	2441 WALLACE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-9215
Country	:	US
Telephone Number	:	718-325-6593
Fax Number	:

Authorized Official
Title or Position	:	SCHOOL NURSE
Name	:	MS. ANGELA VERLEY
Credential	:
Telephone Number	:	718-405-1631

Provider Enumeration Date	:	03/22/2012
Last Update Date	:	03/22/2012

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Directions to “DEPARTMENT OF EDUCATION ” Practice Location

Language	Start Address	Practice Location

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