MEDICARE: DELRAN TOWNSHIP SCHOOL DISTRICT

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)		NJ

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	:	1508106543
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELRAN TOWNSHIP SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	52 HARTFORD RD
Second Line	:
City	:	DELRAN
State	:	NJ
Zip	:	08075-1874
Country	:	US
Telephone Number	:	856-461-6800
Fax Number	:	856-461-6125

Provider Business Practice Location Address
First Line	:	52 HARTFORD RD
Second Line	:
City	:	DELRAN
State	:	NJ
Zip	:	08075-1874
Country	:	US
Telephone Number	:	856-461-6800
Fax Number	:	856-461-6125

Authorized Official
Title or Position	:	BUSINESS ADMINISTRATOR
Name	:	MR. CHRISTOPHER RUSSO
Credential	:
Telephone Number	:	856-461-6800

Provider Enumeration Date	:	02/28/2013
Last Update Date	:	02/28/2013

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Directions to “DELRAN TOWNSHIP SCHOOL DISTRICT ” Practice Location

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