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Individual

ABDUL TEJAN COLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4200 MONUMENT RD, PHILADELPHIA, PA 19131-1625
(215) 929-8829
Mailing address
4200 MONUMENT RD, PHILADELPHIA, PA 19131-1625

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN677631
PA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP026961
PA

Other

Enumeration date
01/20/2023
Last updated
01/20/2023
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