Individual
AUTUMN ELISE COLOSIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5008 BRITTONFIELD PKWY STE 700, EAST SYRACUSE, NY 13057-9249
(315) 472-7504
(315) 634-4677
Mailing address
5008 BRITTONFIELD PKWY STE 700, EAST SYRACUSE, NY 13057-9249
(315) 472-7504
(315) 634-4677
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F343043
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F343043
NYS LICENSE
NY
Enumeration date
10/05/2018
Last updated
10/05/2018
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