Individual
ANTONIO ALVARAS COLACO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
95 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-7001
(845) 703-6999
(845) 703-6297
Mailing address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
(845) 703-6999
(845) 703-6297
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
016235
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03539219
—
NY
Enumeration date
01/21/2013
Last updated
08/06/2020
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