Healthcare Provider Details

I. General information

NPI: 1720224181
Provider Name (Legal Business Name): SCRANTON STATE SCHOOL FOR THE DEAF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2009
Last Update Date: 01/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 N WASHINGTON AVE
SCRANTON PA
18509-1700
US

IV. Provider business mailing address

1800 N WASHINGTON AVE
SCRANTON PA
18509-1700
US

V. Phone/Fax

Practice location:
  • Phone: 570-963-4666
  • Fax: 579-963-4544
Mailing address:
  • Phone: 570-963-4666
  • Fax: 579-963-4544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier100002222 0001
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerMA #

VIII. Authorized Official

Name: DR. MONITA G. HARA
Title or Position: SUPERINTENDENT
Credential: ED.D.
Phone: 570-963-4040