Healthcare Provider Details

I. General information

NPI: 1619056934
Provider Name (Legal Business Name): ELAINE MARIE COLOMBO RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27111 76TH AVE
NEW HYDE PARK NY
11040-1436
US

IV. Provider business mailing address

1414 157TH ST
BEECHHURST NY
11357-2717
US

V. Phone/Fax

Practice location:
  • Phone: 718-289-2270
  • Fax: 718-289-2274
Mailing address:
  • Phone: 718-767-1219
  • Fax: 718-289-2274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number042160
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number042160
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: