Provider Demographics
NPI:1366718728
Name:DEPARTMENT OF EDUCATION
Entity type:Organization
Organization Name:DEPARTMENT OF EDUCATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:STAFF NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:MCDERMOTT
Authorized Official - Suffix:
Authorized Official - Credentials:R/N
Authorized Official - Phone:718-746-0396
Mailing Address - Street 1:147-27 15TH DR.
Mailing Address - Street 2:PS79
Mailing Address - City:QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11357
Mailing Address - Country:US
Mailing Address - Phone:718-746-0396
Mailing Address - Fax:
Practice Address - Street 1:147 27 15TH DR.
Practice Address - Street 2:25Q079
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11357
Practice Address - Country:US
Practice Address - Phone:718-746-0396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY438358-1251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care