Individual
COLETTE C MADISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
77 SULLYS TRAIL, PITTSFORD, NY 14534
(585) 248-5300
(585) 248-3427
Mailing address
800 CARTER STREET, ATTN KELLY STEELE, ROCHESTER, NY 14621
(585) 339-4793
(585) 336-4845
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0074431
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109289BJ
PREFERRED CARE #
NY
01
—
9513997
IHA #
NY
01
—
970028206
MEDICARE RAILROAD #
NY
01
—
P019007443
BLUE CHOICE #
NY
Enumeration date
05/03/2006
Last updated
01/14/2008
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