Individual
DR. LAILA COLICCHIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
104 MARKET ST, PERTH AMBOY, NJ 08861-4412
(732) 826-5159
(732) 826-2107
Mailing address
104 MARKET ST, PERTH AMBOY, NJ 08861-4412
(732) 826-5159
(732) 826-2107
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OA005384
NJ
152W00000X
Optometrist
TO000703
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8972800
—
NJ
Enumeration date
11/08/2005
Last updated
06/15/2011
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