Individual
DR. PATRICK J COLARUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1320 BROADCASTING RD STE 200, WYOMISSING, PA 19610-3222
(610) 372-8995
(610) 685-5984
Mailing address
1320 BROADCASTING RD STE 200, WYOMISSING, PA 19610-3222
(610) 372-8995
(610) 685-5984
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
OS007188L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001601293
—
PA
01
—
888602
MEDICARE PTAN
PA
Enumeration date
08/04/2006
Last updated
10/29/2024
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