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General NPI Number Information
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NPI Number | 1366086936
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Entity Type | Individual
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Provider Name | COLLEEN ELIZABETH SLAWIAK PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/06/2019
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 246 PLEASANT ST BLDG WEST
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City | CONCORD
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State | NH
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Zip | 03301-2548
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Country | US
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Telephone | 603-224-3388
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Fax | 603-227-7536
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Provider Business Mailing Address
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Address Line | 250 PLEASANT ST
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City | CONCORD
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State | NH
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Zip | 03301-2598
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Country | US
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Telephone | 603-227-7000
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA7313
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2881
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License Number State | NH
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