Individual
NATASHA CHANTAY COLEBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
80 SEYMOUR ST, SUITE 502, HARTFORD, CT 06102-8000
(860) 545-0549
(860) 545-5221
Mailing address
150 EILEEN WAY, UNIT 1, SYOSSET, NY 11791-5313
(866) 677-7622
(404) 666-5100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002906
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002906
LICENSE
CT
Enumeration date
04/08/2013
Last updated
01/29/2018
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