Provider Demographics
NPI:1588683148
Name:COLEMAN, PAULA LYNNE (MD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:LYNNE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 959
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-0959
Mailing Address - Country:US
Mailing Address - Phone:845-628-9583
Mailing Address - Fax:845-628-9581
Practice Address - Street 1:7 MILLER ROAD
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-0959
Practice Address - Country:US
Practice Address - Phone:845-628-8788
Practice Address - Fax:845-628-9581
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131265-1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0D0497OtherHEALTHNET
NY133954276OtherPOMCO
NY3747686007OtherCIGNA
NY4326780OtherAETNA
NY180032856OtherRAILROAD MEDICARE
NY9764OtherGHIHMO
NY15B781OtherEMPIRE BLUE SHIELD
NY0499842OtherGHI
NY133954276OtherCARE PLUS
NY177026OtherMVP
NYCO131265-1OtherWORKERS' COMP.
NYSS045OtherOXFORD
NY177026OtherMVP
NYSS045OtherOXFORD