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General NPI Number Information
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NPI Number | 1558770131
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Entity Type | Individual
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Provider Name | BYRON COLEMAN SR. LMSW
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Gender | Male
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Dates
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Enumeration Date | 08/07/2014
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Last Update Date | 08/07/2014
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Provider Practice Location Address
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Address Line | 220 SOMMERVILLE PL APT 1
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City | YONKERS
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State | NY
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Zip | 10703-2278
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Country | US
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Telephone | 914-424-0577
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 342
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City | YONKERS
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State | NY
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Zip | 10705-0342
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Country | US
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Telephone | 914-424-0577
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Fax |
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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 | #092368
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 8280452141
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License Number State | NY
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