Provider Demographics
NPI:1932556909
Name:COLE, SEAN (MSN, NP, ACNPC-AG)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:COLE
Suffix:
Gender:M
Credentials:MSN, NP, ACNPC-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 RED CREEK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-4300
Mailing Address - Country:US
Mailing Address - Phone:585-222-6566
Mailing Address - Fax:
Practice Address - Street 1:600 RED CREEK DR STE 200
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4300
Practice Address - Country:US
Practice Address - Phone:585-222-6566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-19
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY657098163WR0006X
NY431873363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant