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Organization

THOMAS G COYLE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. THOMAS GERARD COYLE (PRINCIPAL)
(917) 566-2313
Entity
Organization

Contact information

Practice address
375 S END AVE, APARTMENT 25 U, NEW YORK, NY 10280-1014
(917) 566-2313
(212) 689-7010
Mailing address
375 SOUTH END AVENUE, APARTMENT 25 U, NEW YORK, NY 10280
(917) 566-2313
(212) 689-7010

Taxonomy

Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
LA - 666357
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LA - 666357
LIFE HEALTH ACCIDENT LICENSE
NY
Enumeration date
12/26/2013
Last updated
12/26/2013
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