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Provider Information for 1083796908

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

MRS. PATRICIA LEN GREEN COFFEY PTA

Gender: FEMALE

Individual NPI: 1083796908

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1083796908
Enumeration Date 2006-10-19
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 6 COMMERCE 382 OLD NORTHERNER RD
DEKALB JCT, NY 13630
United States

Phone: 315-287-7886 | Fax: 315-287-7886
View Map External Link
Primary Practice Address 342 OLD DEKALB RD
CANTON, NY 13617
United States

Phone: 315-386-2647 | Fax: 315-386-4071
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 225200000X - Physical Therapy Assistant NY 0044671