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NPI Code Detail

MEDICARE: CASEY COLE

MEDICARE: CASEY COLE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner406826NY

General Provider Information

NPI Number : 1639968332
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASEY COLE
Provider Business Mailing Address
First Line : 2431 6TH AVE
Second Line :
City : TROY
State : NY
Zip : 12180-2227
Country : US
Telephone Number : 518-423-4630
Fax Number : 518-595-1468
Provider Business Practice Location Address
First Line : 1600 7TH AVE STE 3
Second Line :
City : TROY
State : NY
Zip : 12180-3410
Country : US
Telephone Number : 518-270-2800
Fax Number : 518-270-2707
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2025
Last Update Date : 06/10/2026

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Directions to “ CASEY COLE ” Practice Location

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