Provider Demographics
NPI:1558550293
Name:COLEY, ALBERTHA (RN)
Entity type:Individual
Prefix:MS
First Name:ALBERTHA
Middle Name:
Last Name:COLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12608 SUMMERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1755
Mailing Address - Country:US
Mailing Address - Phone:301-572-5452
Mailing Address - Fax:301-572-5224
Practice Address - Street 1:2160 HOLLAND AVE
Practice Address - Street 2:# B6
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-1779
Practice Address - Country:US
Practice Address - Phone:917-576-7274
Practice Address - Fax:301-572-5224
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238750163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse