Provider Demographics
NPI:1477708535
Name:JOHN A. COLEMAN SCHOL
Entity Type:Organization
Organization Name:JOHN A. COLEMAN SCHOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR OF SCHOOL NURSING SERVIC
Authorized Official - Prefix:MS
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:F
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:646-459-3442
Mailing Address - Street 1:5125 69TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-7515
Mailing Address - Country:US
Mailing Address - Phone:718-672-3471
Mailing Address - Fax:
Practice Address - Street 1:590 AVENUE OF THE AMERICAS
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2019
Practice Address - Country:US
Practice Address - Phone:646-459-3442
Practice Address - Fax:646-459-3689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY481020314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY481020OtherR.N,LICENCE
NY481020OtherRN LICENCE