MEDICARE: LONG BRANCH BOARD OF EDUCATION

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)

General Provider Information

NPI Number	:	1821216565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONG BRANCH BOARD OF EDUCATION

Provider Business Mailing Address
First Line	:	540 BROADWAY
Second Line	:
City	:	LONG BRANCH
State	:	NJ
Zip	:	07740-5905
Country	:	US
Telephone Number	:	732-571-2018
Fax Number	:	732-229-6511

Provider Business Practice Location Address
First Line	:	540 BROADWAY
Second Line	:
City	:	LONG BRANCH
State	:	NJ
Zip	:	07740-5905
Country	:	US
Telephone Number	:	732-571-2018
Fax Number	:	732-229-6511

Authorized Official
Title or Position	:	DRECTOR OF PUPIL PERSONNEL SERVICES
Name	:	MRS. HENRIETTA GRABER
Credential	:
Telephone Number	:	732-571-2018

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	08/22/2020

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Directions to “LONG BRANCH BOARD OF EDUCATION ” Practice Location

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