MEDICARE: BOARD OF EDUCATION OF SEASIDE HEIGHTS

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	:	1881808632
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOARD OF EDUCATION OF SEASIDE HEIGHTS

Provider Business Mailing Address
First Line	:	1200 BAY BLVD
Second Line	:
City	:	SEASIDE HEIGHTS
State	:	NJ
Zip	:	08751-1842
Country	:	US
Telephone Number	:	732-793-8485
Fax Number	:	732-793-8367

Provider Business Practice Location Address
First Line	:	1200 BAY BLVD
Second Line	:
City	:	SEASIDE HEIGHTS
State	:	NJ
Zip	:	08751-1842
Country	:	US
Telephone Number	:	732-793-8485
Fax Number	:	732-793-8367

Authorized Official
Title or Position	:	CST SOCIAL WORKER
Name	:	MR. DAVID ROBERT JULIAN
Credential	:	MSW
Telephone Number	:	732-793-8485

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	06/21/2018

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