Provider Demographics
NPI:1922394964
Name:COLE, INA J
Entity type:Individual
Prefix:MRS
First Name:INA
Middle Name:J
Last Name:COLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 ROKEBY RD
Mailing Address - Street 2:
Mailing Address - City:RED HOOK
Mailing Address - State:NY
Mailing Address - Zip Code:12571-1900
Mailing Address - Country:US
Mailing Address - Phone:845-430-7075
Mailing Address - Fax:
Practice Address - Street 1:122 KYSERIKE RD
Practice Address - Street 2:
Practice Address - City:ACCORD
Practice Address - State:NY
Practice Address - Zip Code:12404-0009
Practice Address - Country:US
Practice Address - Phone:845-626-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007771-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist