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General NPI Number Information
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NPI Number | 1518978212
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Entity Type | Individual
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Provider Name | ROBERT EDWARD COLEMAN LCSW
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Gender | Male
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 108-19 ROCKAWAY BLVD
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City | OZONE PARK
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State | NY
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Zip | 11420
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Country | US
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Telephone | 718-845-2620
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Fax | 718-845-9380
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Provider Business Mailing Address
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Address Line | 472 WEST 144 STREET APT.#1
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City | NEW YORK
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State | NY
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Zip | 10031
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Country | US
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Telephone | 212-491-1747
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Fax | 718-845-9380
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 00029490
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License Number State | NY
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