Provider Demographics
NPI:1306349923
Name:SPEIGHT, COLLEEN ANN
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:ANN
Last Name:SPEIGHT
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 1:525 RIVERDALE AVE APT 4B
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-3590
Mailing Address - Country:US
Mailing Address - Phone:845-265-9050
Mailing Address - Fax:
Practice Address - Street 1:525 RIVERDALE AVE APT 4B
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-3590
Practice Address - Country:US
Practice Address - Phone:845-265-9050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-09
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist