Provider Demographics
NPI:1417361122
Name:MARIA C. COE, MSRD,CDN,PC
Entity Type:Organization
Organization Name:MARIA C. COE, MSRD,CDN,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:CORAZON
Authorized Official - Last Name:COE
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:718-545-1632
Mailing Address - Street 1:3135 31ST ST
Mailing Address - Street 2:UNIT 303
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11106-2591
Mailing Address - Country:US
Mailing Address - Phone:718-545-1632
Mailing Address - Fax:718-898-1093
Practice Address - Street 1:10211 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-2331
Practice Address - Country:US
Practice Address - Phone:718-898-1386
Practice Address - Fax:718-898-1903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003935261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service