Healthcare Provider Details

I. General information

NPI: 1386724086
Provider Name (Legal Business Name): WINCHESTER PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 05/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 PRATT ST
WINSTED CT
06098-2061
US

IV. Provider business mailing address

201 PRATT ST
WINSTED CT
06098-2061
US

V. Phone/Fax

Practice location:
  • Phone: 860-379-0706
  • Fax: 860-738-0638
Mailing address:
  • Phone: 860-379-0706
  • Fax: 860-738-0638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170100000X
TaxonomyPh.D. Medical Genetics
License Number25130000X
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: MS. STACY A SCHMIDT
Title or Position: PURCHASING/ACCTS RECEIVABLE
Credential:
Phone: 860-379-0706