Provider Demographics
NPI:1598996381
Name:COLE, DAVIN ROCKWELL (PA)
Entity Type:Individual
Prefix:MR
First Name:DAVIN
Middle Name:ROCKWELL
Last Name:COLE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:MR
Other - First Name:DAVIN
Other - Middle Name:ROCKWELL
Other - Last Name:DOBNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:890 HUNTS POINT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10474-5402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:890 HUNTS POINT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10474-5402
Practice Address - Country:US
Practice Address - Phone:718-589-2141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013400363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant