Individual
MRS. SHAUN MARIE COLAVITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
319 PROSPECT POINT RD, LAKE HOPATCONG, NJ 07849-1206
(862) 812-4556
Mailing address
319 PROSPECT POINT RD, LAKE HOPATCONG, NJ 07849
(862) 812-4556
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
40QB00248500
NJ
Other
Enumeration date
04/24/2013
Last updated
04/24/2013
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