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General NPI Number Information
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NPI Number | 1003313206
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Entity Type | Individual
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Provider Name | COLLEEN KILBOURNE TRACY MD
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Gender | Female
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Dates
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Enumeration Date | 04/12/2018
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 60 RED JACKET ST STE 1
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City | DANSVILLE
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State | NY
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Zip | 14437-1769
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Country | US
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Telephone | 585-335-6041
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Fax | 585-335-6764
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Provider Business Mailing Address
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Address Line | 10869 STATE ROUTE 36
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City | DANSVILLE
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State | NY
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Zip | 14437-9444
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Country | US
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Telephone | 585-335-3100
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Fax | 585-335-8695
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 307993
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License Number State | NY
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