Healthcare Provider Details

I. General information

NPI: 1922680693
Provider Name (Legal Business Name): BROOKLAWN BOARD OF EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 04/22/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 HAAKON RD
BROOKLAWN NJ
08030-2717
US

IV. Provider business mailing address

301 HAAKON RD
BROOKLAWN NJ
08030-2717
US

V. Phone/Fax

Practice location:
  • Phone: 856-456-4039
  • Fax:
Mailing address:
  • Phone: 856-456-4039
  • Fax:

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: DR. SAMUEL ROSETTI
Title or Position: SUPERINTENDENT
Credential: ED. D.
Phone: 856-456-4039