Commonwealth of Pennsylvania Department of Education

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF EDUCATION

Practice address

75 Kiwanis Blvd
West Hazleton, PA 18202-1157

Phone

(570) 455-8511

Fax

(570) 455-4526

NPI assigned

Jul 25, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gloria Grego

Title

Director, PA Medicaid SCH Based PRG

Phone

(570) 455-8511

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219276800000",
    "number": "1245430438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 KIWANIS BLVD",
            "city": "WEST HAZLETON",
            "state": "PA",
            "postal_code": "182021157",
            "telephone_number": "570-455-8511",
            "fax_number": "570-455-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 KIWANIS BLVD",
            "city": "WEST HAZLETON",
            "state": "PA",
            "postal_code": "182021157",
            "telephone_number": "570-455-8511",
            "fax_number": "570-455-4526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF EDUCATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2008-08-21",
        "status": "A",
        "authorized_official_last_name": "GREGO",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "DIRECTOR, PA MEDICAID SCH BASED PRG",
        "authorized_official_telephone_number": "570-455-8511"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000022220002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Teresa Berrettini, RPH
• Kenneth Charles Boyle, DMD
• Shannon Carper, PT, DPT
• Helen J. Chandoha-Knott, O.D.
• Jessica Cusatis
• Cussatt Eyewear
• Cussatt Optical
• Joseph D Cussatt
• James Edward Dormer Jr.

• Local Education Agency (LEA) in West Hazleton, PA
• Providers in West Hazleton, PA by specialty
• Local Education Agency (LEA) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.