Healthcare Provider Details

I. General information

NPI: 1407327562
Provider Name (Legal Business Name): ASHLEY MARIE COLE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 12/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 KENSINGTON AVE
BUFFALO NY
14214-2897
US

IV. Provider business mailing address

458 AUBURN AVE
BUFFALO NY
14213-1640
US

V. Phone/Fax

Practice location:
  • Phone: 716-816-4459
  • Fax:
Mailing address:
  • Phone: 315-561-3844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number720730
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: