Provider Demographics
NPI:1609868074
Name:COLES, NANCY H (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:H
Last Name:COLES
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 1:125 E 72ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4250
Mailing Address - Country:US
Mailing Address - Phone:212-879-8886
Mailing Address - Fax:212-879-8887
Practice Address - Street 1:125 E 72ND ST
Practice Address - Street 2:1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4250
Practice Address - Country:US
Practice Address - Phone:212-879-8886
Practice Address - Fax:212-879-8887
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16651-1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D92015Medicare UPIN
08F401Medicare ID - Type Unspecified