Provider Demographics
NPI:1558740704
Name:VINCENT, COLETTE (FNP)
Entity type:Individual
Prefix:
First Name:COLETTE
Middle Name:
Last Name:VINCENT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4057 BAYCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-2313
Mailing Address - Country:US
Mailing Address - Phone:931-922-1239
Mailing Address - Fax:
Practice Address - Street 1:907 E TREMONT AVE FL 2
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-4301
Practice Address - Country:US
Practice Address - Phone:914-469-0700
Practice Address - Fax:914-306-8240
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3402015363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily