1184944720 NPI number — MS. SOPHIA ANDREA WALKER-COLE FNP

Table of content: MS. SOPHIA ANDREA WALKER-COLE FNP (NPI 1184944720)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184944720 NPI number — MS. SOPHIA ANDREA WALKER-COLE FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WALKER-COLE
Provider First Name:
SOPHIA
Provider Middle Name:
ANDREA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184944720
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/27/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
SOPHIA WALKER-COLE
Provider Second Line Business Mailing Address:
1975 LINDEN BLVD, SUITE 202
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-725-6706
Provider Business Mailing Address Fax Number:
516-531-8781

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1975 LINDEN BLVD STE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELMONT
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11003-4004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-664-2932
Provider Business Practice Location Address Fax Number:
516-531-8781
Provider Enumeration Date:
06/06/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  335680 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 335680 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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