Individual
BENJAMIN TYLER COLWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
501 NEW KARNER RD, ALBANY, NY 12205-3874
(518) 393-0391
Mailing address
711 TROY SCHENECTADY RD STE 201, LATHAM, NY 12110-2461
(518) 783-3700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
025691
NY
Other
Enumeration date
03/30/2020
Last updated
09/28/2020
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