Provider Demographics
NPI:1790930501
Name:JOHN A COLEMAN SCHOOL
Entity Type:Organization
Organization Name:JOHN A COLEMAN SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:MISSAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:646-349-3400
Mailing Address - Street 1:3092 ANN ST
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-4504
Mailing Address - Country:US
Mailing Address - Phone:515-546-7375
Mailing Address - Fax:
Practice Address - Street 1:3092 ANN ST
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-4504
Practice Address - Country:US
Practice Address - Phone:515-546-7375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY360553-13140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY360553-1OtherRN