Healthcare Provider Details

I. General information

NPI: 1932355732
Provider Name (Legal Business Name): DAVID A. COLBERT M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2008
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 5TH AVE 4TH FLOOR
NEW YORK NY
10003-1007
US

IV. Provider business mailing address

119 5TH AVE 4TH FLOOR
NEW YORK NY
10003-1007
US

V. Phone/Fax

Practice location:
  • Phone: 212-533-8888
  • Fax: 212-673-5185
Mailing address:
  • Phone: 212-533-8888
  • Fax: 212-673-5185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NANCY FONSECA
Title or Position: CLAIMS MANAGER
Credential:
Phone: 646-442-5002