Healthcare Provider Details

I. General information

NPI: 1710990718
Provider Name (Legal Business Name): EAST HARTFORD PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 08/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 FORBES ST JOSEPH O. GOODWIN ELEMENTARY SCHOOL
EAST HARTFORD CT
06118-2803
US

IV. Provider business mailing address

1235 FORBES ST JOSEPH O. GOODWIN ELEMENTARY SCHOOL
EAST HARTFORD CT
06118-2803
US

V. Phone/Fax

Practice location:
  • Phone: 860-622-5431
  • Fax: 860-622-5432
Mailing address:
  • Phone: 860-622-5431
  • Fax: 860-622-5432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. SHARON BREMNER
Title or Position: DIRECTOR PUPIL PERSONNELL SERVICES
Credential: DED
Phone: 860-622-5110