Individual
CORAL COLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
165 PASSAIC AVE, FAIRFIELD, NJ 07004-3521
(862) 367-3153
Mailing address
190 CALDWELL AVE, PATERSON, NJ 07501-2514
(862) 367-3153
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
6NR25489700
NJ
163WH0200X
Home Health Registered Nurse
6NR25489700
NJ
Other
Enumeration date
01/17/2024
Last updated
02/06/2024
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