Healthcare Provider Details

I. General information

NPI: 1689021594
Provider Name (Legal Business Name): NEW LONDON PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2016
Last Update Date: 05/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 WILLIAMS ST
NEW LONDON CT
06320-5231
US

IV. Provider business mailing address

134 WILLIAMS ST
NEW LONDON CT
06320-5231
US

V. Phone/Fax

Practice location:
  • Phone: 860-447-6000
  • Fax: 860-447-6026
Mailing address:
  • Phone: 860-447-6000
  • Fax: 860-447-6026

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: KRISTINA S JORDAN
Title or Position: DIRECTOR OF SPECIAL SERVICES
Credential:
Phone: 860-447-6010