Provider Demographics
NPI:1306454210
Name:COLEMAN, JASMIN ALON (MS)
Entity type:Individual
Prefix:
First Name:JASMIN
Middle Name:ALON
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MRS
Other - First Name:JASMIN
Other - Middle Name:A
Other - Last Name:FERRELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:500 W 30TH ST APT 31E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-1382
Mailing Address - Country:US
Mailing Address - Phone:646-641-9509
Mailing Address - Fax:
Practice Address - Street 1:255 EXECUTIVE DR STE LL105
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1718
Practice Address - Country:US
Practice Address - Phone:516-576-0962
Practice Address - Fax:516-349-0961
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1410832201174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist