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General NPI Number Information
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NPI Number | 1114042553
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Entity Type | Organization
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Legal Business Name | EAST LYME BOARD OF ED
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 05/04/2016
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Provider Practice Location Address
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Address Line | 165 BOSTON POST RD
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City | EAST LYME
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State | CT
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Zip | 06333-1605
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Country | US
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Telephone | 860-739-1208
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Fax |
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Provider Business Mailing Address
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Address Line | 165 BOSTON POST RD
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City | EAST LYME
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State | CT
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Zip | 06333-1605
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIR OF SPED
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Name | STEPHEN BUCK
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Credential |
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Telephone | 860-739-1208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 004208262
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License Number State | CT
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