Colette Pauline Elder

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

8 Osage LN
Staten Island, NY 10312-6124

Phone

(917) 939-0602

NPI assigned

Jun 5, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Colette Pauline Elder Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367193600000",
    "number": "1184985293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 OSAGE LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126124",
            "telephone_number": "917-939-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 OSAGE LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126124",
            "telephone_number": "917-939-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDER",
        "first_name": "COLETTE",
        "middle_name": "PAULINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-05",
        "last_updated": "2013-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLETTE",
            "last_name": "ELDER",
            "middle_name": "PAULINE",
            "credential": "MSED",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Staten Island, NY
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.