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General NPI Number Information
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NPI Number | 1699199661
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Entity Type | Organization
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Legal Business Name | ORANGE-ULSTER BOARD OF COOPERATIVE EDUCATIONAL SERVICES
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Dates
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Enumeration Date | 02/12/2014
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 53 GIBSON RD
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City | GOSHEN
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State | NY
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Zip | 10924-6709
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Country | US
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Telephone | 845-291-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 53 GIBSON RD
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City | GOSHEN
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State | NY
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Zip | 10924-6709
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Country | US
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Telephone | 845-291-0100
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Fax |
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Authorized Official
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Title or Position | SCHOOL NURSE TEACHER
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Name | MRS. MAUREEN KUSSARD
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Credential | RN, SNT
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Telephone | 845-291-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 630218
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License Number State | NY
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