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Individual

SAMANTHA COLOSI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1500 WALNUT ST STE 1240, PHILADELPHIA, PA 19102-3524
(267) 687-4437
Mailing address
1500 WALNUT ST STE 1240, PHILADELPHIA, PA 19102-3524
(267) 687-4437

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
25MP00377900
NJ
363A00000X
Physician Assistant
OA003613
PA
363AM0700X
Medical Physician Assistant
Primary
MA057786
PA

Other

Enumeration date
10/18/2015
Last updated
07/19/2016
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