Healthcare Provider Details

I. General information

NPI: 1639355506
Provider Name (Legal Business Name): JILL ELAINE COLABROY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2008
Last Update Date: 04/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 W PUMPING STATION RD STE 4
QUAKERTOWN PA
18951-2345
US

IV. Provider business mailing address

PO BOX 1754
ALLENTOWN PA
18105-1754
US

V. Phone/Fax

Practice location:
  • Phone: 215-529-4270
  • Fax: 215-529-4293
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number048525
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD442806
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: