Provider Demographics
NPI:1194870337
Name:COLE, ELEANOR
Entity type:Individual
Prefix:DR
First Name:ELEANOR
Middle Name:
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 1:223 BLOOMFIELD ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-4747
Mailing Address - Country:US
Mailing Address - Phone:201-659-2223
Mailing Address - Fax:201-659-2223
Practice Address - Street 1:223 BLOOMFIELD ST
Practice Address - Street 2:SUITE 111
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-4747
Practice Address - Country:US
Practice Address - Phone:201-659-2223
Practice Address - Fax:201-659-2223
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI02900103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5500605Medicaid
NJR98439Medicare UPIN
NJ5500605Medicaid