Provider Demographics
NPI:1083047708
Name:COYLE, ARLENE MARY (RN)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:MARY
Last Name:COYLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9430 RIDGE BLVD
Mailing Address - Street 2:APT 3A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-6756
Mailing Address - Country:US
Mailing Address - Phone:718-759-7294
Mailing Address - Fax:
Practice Address - Street 1:9430 RIDGE BLVD
Practice Address - Street 2:APT 3A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-6756
Practice Address - Country:US
Practice Address - Phone:718-759-7294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY439446163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse