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General NPI Number Information
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NPI Number | 1477708535
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Entity Type | Organization
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Legal Business Name | JOHN A. COLEMAN SCHOL
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Dates
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Enumeration Date | 11/17/2008
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Last Update Date | 11/17/2008
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Provider Practice Location Address
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Address Line | 590 AVENUE OF THE AMERICAS
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City | NEW YORK
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State | NY
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Zip | 10011-2019
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Country | US
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Telephone | 646-459-3442
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Fax | 646-459-3689
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Provider Business Mailing Address
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Address Line | 5125 69TH ST
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City | WOODSIDE
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State | NY
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Zip | 11377-7515
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Country | US
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Telephone | 718-672-3471
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Fax |
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Authorized Official
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Title or Position | SUPERVISOR OF SCHOOL NURSING SERVIC
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Name | MS. BLANCA F RODRIGUEZ
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Credential | REGISTERED NURSE
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Telephone | 646-459-3442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 481020
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License Number State | NY
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