Individual
MS. BEVERLY A. COLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
150 EAST 45TH STREET, LORD MEMORIAL CLINIC, NEW YORK, NY 10017-3192
(212) 949-4958
(212) 682-2613
Mailing address
150 EAST 45TH STREET SUITE 227, CHILDREN'S AID SOCIETY, NEW YORK, NY 10017-3192
(212) 949-4958
(212) 682-2613
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000296-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00245423
—
NY
Enumeration date
10/10/2012
Last updated
10/10/2012
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