Healthcare Provider Details

I. General information

NPI: 1386581411
Provider Name (Legal Business Name): EAST GRANBY BOARD OF EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 TURKEY HILLS RD
EAST GRANBY CT
06026-9570
US

IV. Provider business mailing address

33 TURKEY HILLS RD
EAST GRANBY CT
06026-9570
US

V. Phone/Fax

Practice location:
  • Phone: 860-653-6486
  • Fax: 860-413-9075
Mailing address:
  • Phone: 860-653-6486
  • Fax: 860-413-9075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSHUA TADD MARTIN
Title or Position: DIRECTOR OF STUDENT SUPPORT SERVICE
Credential:
Phone: 860-413-9079