Provider Demographics
NPI:1730452202
Name:MARLBOROUGH PUBLIC SCHOOLS
Entity type:Organization
Organization Name:MARLBOROUGH PUBLIC SCHOOLS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:STOLGITIS
Authorized Official - Suffix:
Authorized Official - Credentials:CPNP-PC
Authorized Official - Phone:508-624-6934
Mailing Address - Street 1:29 AVALON DR
Mailing Address - Street 2:PO BOX 194
Mailing Address - City:WEST BROOKFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01585-2741
Mailing Address - Country:US
Mailing Address - Phone:617-939-6681
Mailing Address - Fax:
Practice Address - Street 1:80 FOLEY RD
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-1922
Practice Address - Country:US
Practice Address - Phone:508-624-6934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA217062261Q00000X, 282NC2000X, 281PC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281PC2000XHospitalsChronic Disease HospitalChildren
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No282NC2000XHospitalsGeneral Acute Care HospitalChildren