Provider Demographics
NPI:1124497532
Name:COLFORD, NYLA EVETTE (CRNA)
Entity type:Individual
Prefix:
First Name:NYLA
Middle Name:EVETTE
Last Name:COLFORD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:NYLA
Other - Middle Name:E
Other - Last Name:SAOUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1275 YORK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1275 YORK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6007
Practice Address - Country:US
Practice Address - Phone:212-639-2000
Practice Address - Fax:646-422-2088
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6508541163W00000X
NJ26NR14883500163WC0200X
NY650854367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine