Basic Information
| Provider Information | |||||||||
| NPI: | 1780951202 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COLEMAN | ||||||||
| FirstName: | JOANNA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MS. | ||||||||
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| OtherLastName: | COSCI | ||||||||
| OtherFirstName: | JOANNA | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 640 BELLE TERRE RD. | ||||||||
| Address2: | SUITE J4 EAR WORKS, P.C. | ||||||||
| City: | PORT JEFFERSON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11777 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6319284599 | ||||||||
| FaxNumber: | 5615987231 | ||||||||
| Practice Location | |||||||||
| Address1: | 640 BELLE TERRE RD. | ||||||||
| Address2: | SUITE J4 EAR WORKS AUDIOLOGY | ||||||||
| City: | PORT JEFFERSON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11777 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6319284599 | ||||||||
| FaxNumber: | 7183231134 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/29/2011 | ||||||||
| LastUpdateDate: | 12/13/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | NY | N | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | 237700000X | 14000034148 | NY | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.