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Individual

PROF. DAMARIS COLLADO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
9320 A ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372
(718) 334-6793
(718) 334-6717
Mailing address
9320 A ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372
(718) 334-6793
(718) 334-6717

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
00005580
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02044764
NY
Enumeration date
04/24/2009
Last updated
04/24/2009
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