MEDICARE: NORTHEAST BRADFORD 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)		PA

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	:	1760427306
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHEAST BRADFORD SCHOOL DISTRICT

Provider Business Mailing Address
First Line	:	RR 1 BOX 211B
Second Line	:
City	:	ROME
State	:	PA
Zip	:	18837-9505
Country	:	US
Telephone Number	:	570-744-2521
Fax Number	:

Provider Business Practice Location Address
First Line	:	RR 1 BOX 211B
Second Line	:
City	:	ROME
State	:	PA
Zip	:	18837-9505
Country	:	US
Telephone Number	:	570-744-2521
Fax Number	:

Authorized Official
Title or Position	:	SCHOOL PSYCH/SPECIAL ED COORDINATOR
Name	:	DR. LINDA E SPEARS
Credential	:	PSY.D.
Telephone Number	:	570-744-2521

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	08/22/2020

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