Provider Demographics
NPI:1750651469
Name:JOHN A. COLEMAN SCHOOL
Entity Type:Organization
Organization Name:JOHN A. COLEMAN SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:LA SCALIA
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:631-484-3812
Mailing Address - Street 1:2 CANFIELD AVE APT 832
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-2054
Mailing Address - Country:US
Mailing Address - Phone:631-484-3812
Mailing Address - Fax:
Practice Address - Street 1:2 CANFIELD AVENUE
Practice Address - Street 2:APT #832
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601
Practice Address - Country:US
Practice Address - Phone:631-484-3812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021359251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)