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General NPI Number Information
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NPI Number | 1669035820
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Entity Type | Individual
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Provider Name | EMILY LACY COLEMAN MD
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Gender | Female
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Dates
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Enumeration Date | 04/15/2019
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 1415 TULANE AVE FL 5
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City | NEW ORLEANS
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State | LA
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Zip | 70112-2600
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Country | US
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Telephone | 504-988-1700
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Fax | 504-988-1721
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Provider Business Mailing Address
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Address Line | 64 ROBBINS ST
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City | WATERBURY
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State | CT
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Zip | 06708-2600
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Country | US
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Telephone | 203-573-6162
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Fax | 203-573-6707
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 339672
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License Number State | LA
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