Healthcare Provider Details

I. General information

NPI: 1316921885
Provider Name (Legal Business Name): THOMAS J COLE
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WEST AVE SUITE 205
SARATOGA SPRINGS NY
12866-6045
US

IV. Provider business mailing address

226 NELSON AVE
SARATOGA SPRINGS NY
12866-3419
US

V. Phone/Fax

Practice location:
  • Phone: 518-581-8699
  • Fax: 518-581-8783
Mailing address:
  • Phone: 518-583-3208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR034349
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: