MEDICARE: LONG BEACH PUBLIC SCHOOLS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265581862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONG BEACH PUBLIC SCHOOLS

Provider Business Mailing Address
First Line	:	601 LINDELL BLVD
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-1736
Country	:	US
Telephone Number	:	516-897-2200
Fax Number	:	516-897-2208

Provider Business Practice Location Address
First Line	:	601 LINDELL BLVD
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-1736
Country	:	US
Telephone Number	:	516-897-2200
Fax Number	:	516-897-2208

Authorized Official
Title or Position	:	DIRECTOR OF PUPIL SERVICES
Name	:	DR. MARY TATEM
Credential	:	PSY.D.
Telephone Number	:	516-897-2200

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	08/22/2020

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Directions to “LONG BEACH PUBLIC SCHOOLS ” Practice Location

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