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General NPI Number Information
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NPI Number | 1184980328
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Entity Type | Organization
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Legal Business Name | SHEILA DEFORD COFIELD SLP, P.C.
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Dates
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Enumeration Date | 04/02/2012
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Last Update Date | 04/02/2012
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Provider Practice Location Address
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Address Line | 37 ELDRIDGE AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10302-2308
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Country | US
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Telephone | 347-645-0961
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Fax | 718-715-0266
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Provider Business Mailing Address
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Address Line | 37 ELDRIDGE AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10302-2308
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Country | US
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Telephone | 347-645-0961
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Fax | 718-715-0266
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MRS. SHEILA D COFIELD
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Credential |
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Telephone | 347-645-0961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 004857
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License Number State | NY
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