Healthcare Provider Details

I. General information

NPI: 1871832006
Provider Name (Legal Business Name): HACKENSACK BOARD OF EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2013
Last Update Date: 02/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 2ND ST
HACKENSACK NJ
07601-2417
US

IV. Provider business mailing address

191 2ND ST
HACKENSACK NJ
07601-2417
US

V. Phone/Fax

Practice location:
  • Phone: 201-646-0295
  • Fax: 201-646-0418
Mailing address:
  • Phone: 201-646-0295
  • Fax: 201-646-0418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MARK STEVEN KRAMER
Title or Position: SCHOOL BUSINESS ADMINISTRATOR
Credential:
Phone: 201-646-0295