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Individual

ANTHONY COLAVITA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6334 ELMWOOD AVE, PHILA, PA 19142
(215) 726-7066
(215) 724-5911
Mailing address
411 WILLIAMSON RD, GLADWYNE, PA 19035

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD0330026
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0668091
PA
Enumeration date
04/02/2007
Last updated
07/01/2013
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