Individual
PASQUALE A COLAVITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2230 S BROAD ST, PHILA, PA 19145-3950
(215) 334-3869
(215) 755-3300
Mailing address
2230 S BROAD ST, PHILA, PA 19145-3950
(215) 334-3869
(215) 755-3300
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OS008864L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016964390001
—
PA
Enumeration date
03/22/2006
Last updated
05/03/2013
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