Individual
DR. RICHARD D COLAVITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
285 DAVIDSON AVE, SUITE 204, SOMERSET, NJ 08873-4153
(732) 271-1400
(732) 271-3543
Mailing address
285 DAVIDSON AVE, SUITE 204, SOMERSET, NJ 08873-4153
(732) 271-1400
(732) 271-3543
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MA51220
NJ
207LP2900X
Pain Medicine (Anesthesiology) Physician
25MA05122000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1788205M1J
MEDICARE PTAN
NJ
05
—
4543631
—
NJ
Enumeration date
04/20/2006
Last updated
03/12/2013
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