Individual
LYNN ANN COLAIACOVO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2501 SHENANGO VALLEY FWY, STE 1, HERMITAGE, PA 16148-2536
(724) 983-1820
(724) 983-1822
Mailing address
2501 SHENANGO VALLEY FWY, STE 1, HERMITAGE, PA 16148-2536
(724) 983-1820
(724) 983-1822
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD057934L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000160272
MEDPLUS
PA
01
—
000000352669
ANTHEM
OH
01
—
000662020
HIGHMARK
PA
05
—
0016268820006
—
PA
01
—
101761
UPMC
PA
01
—
1500331
GATEWAY
PA
01
—
201894518
TRICARE
PA
01
—
P00204247
RAILROAD MEDICARE
GA
Enumeration date
06/13/2005
Last updated
07/08/2007
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