Provider Demographics
NPI:1942631031
Name:COLONEY, JAY ALAN
Entity Type:Individual
Prefix:MR
First Name:JAY
Middle Name:ALAN
Last Name:COLONEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 PUBLIC AVE
Mailing Address - Street 2:PO BOX 432
Mailing Address - City:MONTROSE
Mailing Address - State:PA
Mailing Address - Zip Code:18801-1220
Mailing Address - Country:US
Mailing Address - Phone:607-206-4799
Mailing Address - Fax:607-797-7601
Practice Address - Street 1:38 MARGARET ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-3016
Practice Address - Country:US
Practice Address - Phone:607-206-4799
Practice Address - Fax:607-797-7601
Is Sole Proprietor?:No
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst