Provider Demographics
NPI:1023134301
Name:CITY OF FITCHBURG
Entity type:Organization
Organization Name:CITY OF FITCHBURG
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PUPIL PERSONNEL
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHREIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-345-3211
Mailing Address - Street 1:376 SOUTH ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-7942
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:376 SOUTH ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-7942
Practice Address - Country:US
Practice Address - Phone:978-345-3211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1950452Medicaid