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NPI Code Detail

MEDICARE: SANDRA LEE COLEMAN NP

MEDICARE: SANDRA LEE COLEMAN NP
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
1363LF0000XFamily Nurse Practitioner333848NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1115994DLOTHERNYPREFERRED CARE
26613OTHERNYBLUE CROSS ROCHESTER
3P019333848OTHERNYBLUE CHOICE ROCHESTER
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801810874
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA LEE COLEMAN NP
Provider Business Mailing Address
First Line : 82 HOLLAND ST
Second Line :
City : ROCHESTER
State : NY
Zip : 14605-2131
Country : US
Telephone Number : 585-423-2800
Fax Number : 585-423-2868
Provider Business Practice Location Address
First Line : 82 HOLLAND ST
Second Line :
City : ROCHESTER
State : NY
Zip : 14605-2131
Country : US
Telephone Number : 585-423-2800
Fax Number : 585-423-2868
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 01/25/2011

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