Individual
EDWARD COLUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
1421 E 2ND ST, BROOKLYN, NY 11230-5501
(718) 645-7337
Mailing address
18 ROME AVE, STATEN ISLAND, NY 10304-4318
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
015394-1
NY
Other
Enumeration date
01/04/2012
Last updated
01/04/2012
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