Healthcare Provider Details

I. General information

NPI: 1033296280
Provider Name (Legal Business Name): NEW LONDON PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 JEFFERSON AVE NEW LONDON HIGH SCHOOL
NEW LONDON CT
06320-2525
US

IV. Provider business mailing address

134 WILLIAMS ST
NEW LONDON CT
06320-5231
US

V. Phone/Fax

Practice location:
  • Phone: 860-437-6400
  • Fax: 860-437-6440
Mailing address:
  • Phone: 860-447-6010
  • Fax: 860-447-6026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCT

VIII. Authorized Official

Name: MRS. CHRISTINE L CARVER
Title or Position: DIRECTOR OF SPECIAL SERVICES
Credential:
Phone: 860-447-6010