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Individual

CRYSTAL COLON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
2265 3RD AVE, BORIKEN NEIGHBORHOOD HEALTH CENTER, NEW YORK, NY 10035-2231
(212) 289-6650
(212) 360-5088
Mailing address
2265 3RD AVE, BORIKEN NEIGHBORHOOD HEALTH CENTER, NEW YORK, NY 10035-2231
(212) 289-6650
(212) 360-5088

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
091558
NY
104100000X
Social Worker
916659022
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00355940
NY
01
1285628552
AGENCIES
NY
01
WVE061
MEDICARE #
NY
Enumeration date
07/21/2014
Last updated
03/09/2015
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