Individual
COLLEEN BACKUS
Active
Individual
COLLEEN BACKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006568
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000492521001
BLUE SHIELD OF NORTHEASTE
NY
01
—
10000074
CDPHP
NY
01
—
2289411
AETNA HMO
NY
01
—
43115
MVP HEALTH PLAN
NY
01
—
5683569
AETNA PPO
NY
01
—
Q55081
EMPIRE BLUE CROSS
NY
Enumeration date
04/11/2006
Last updated
07/09/2007
Update your record
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