Individual
COLLEEN ANN ROSALIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
895 MONTAUK HWY, SHIRLEY, NY 11967-2127
(631) 230-5770
Mailing address
27 HAWKS NEST RD, STONY BROOK, NY 11790-1103
(631) 413-5097
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006265
NY
Other
Enumeration date
02/16/2023
Last updated
02/16/2023
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