National Provider Identifier

Coleman Pettway Jr.

Coleman Pettway Jr. is listed in the NPPES registry with a primary specialty of Social Worker in Buffalo, NY and a listed phone number of (516) 592-8452.

NPI 1588269989Buffalo, NYSocial Worker

Profile Overview

NPI
1588269989
Provider Type
Individual
Primary Specialty
Social Worker
Enumeration Date
December 02, 2020
Last Updated
December 02, 2020

Practice Location

  • 89 Butler Ave
  • Buffalo, NY 14208-1517

Phone: (516) 592-8452

Mailing Address

  • PO Box 641
  • Buffalo, NY 14215-0641

Specialties

  • Social Worker (104100000X)

Endpoints

  • C.Pettway@gmail.com

    Connect Url | Direct | Buffalo, NY 14208

    Professional Email

Full Record
NPI
1588269989
Entity Type
Individual
Last Name
Pettway
First Name
Coleman
Name Prefix
Mr.
Name Suffix
Jr.
Mailing Street Address
PO Box 641
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14215-0641
Mailing Country
US
Mailing Phone
(516) 592-8452
Practice Street Address
89 Butler Ave
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14208-1517
Practice Country
US
Practice Phone
(516) 592-8452
Enumeration Date
December 02, 2020
Last Updated
December 02, 2020
Sex
Male
Sole Proprietor
Yes
Certification Date
December 02, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Social Worker (104100000X)