Provider Demographics
NPI:1801030952
Name:O'BRIEN-COLE, MATIE (RN/MA)
Entity Type:Individual
Prefix:MRS
First Name:MATIE
Middle Name:
Last Name:O'BRIEN-COLE
Suffix:
Gender:F
Credentials:RN/MA
Other - Prefix:MR
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:O'BRIEN-COLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1812 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-1103
Mailing Address - Country:US
Mailing Address - Phone:908-578-6560
Mailing Address - Fax:
Practice Address - Street 1:1812 FRONT ST
Practice Address - Street 2:CEO CORPORATE CENTER
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-1103
Practice Address - Country:US
Practice Address - Phone:908-578-6560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO08328800163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health