Healthcare Provider Details

I. General information

NPI: 1538319595
Provider Name (Legal Business Name): JAMES JOSEPH COLAMARIA JR. NPP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2008
Last Update Date: 09/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 HEMLOCK DR
GREENFIELD CENTER NY
12833-1212
US

IV. Provider business mailing address

38 HEMLOCK DR
GREENFIELD CENTER NY
12833-1212
US

V. Phone/Fax

Practice location:
  • Phone: 518-587-5403
  • Fax: 518-587-1878
Mailing address:
  • Phone: 518-587-5403
  • Fax: 518-587-1878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF401161-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: