Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 25MA07954300 | NJ |
N | 2081P2900X | Pain Medicine | 141612 | NY |
N | 2081P2900X | Pain Medicine | 25MA07954300 | NJ |
NPI | 1386646305 |
---|---|
Provider Name | Dr. Jeffrey Lewis Cole |
First Address | Great Neck, NY 11023-1347 |
Second Address | Forest Hills, NY 11375-4365 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 01/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C04491 | (02) | NJ |