Provider Demographics
NPI:1659419364
Name:COLE, DORI A
Entity Type:Individual
Prefix:DR
First Name:DORI
Middle Name:A
Last Name:COLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 SOUNDVIEW RD
Mailing Address - Street 2:STE 2
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2965
Mailing Address - Country:US
Mailing Address - Phone:203-458-8818
Mailing Address - Fax:203-453-1988
Practice Address - Street 1:37 SOUNDVIEW RD
Practice Address - Street 2:STE 2
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2965
Practice Address - Country:US
Practice Address - Phone:203-458-8818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001117111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTU56787Medicare UPIN