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General NPI Number Information
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NPI Number | 1548641277
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Entity Type | Individual
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Provider Name | COLLEEN MORELAND DO
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Gender | Female
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Dates
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Enumeration Date | 06/18/2015
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 1367 WASHINGTON AVE STE 200
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City | ALBANY
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State | NY
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Zip | 12206-1048
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Country | US
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Telephone | 518-631-3286
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Fax |
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Provider Business Mailing Address
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Address Line | 1367 WASHINGTON AVE STE 200
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City | ALBANY
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State | NY
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Zip | 12206-1048
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Country | US
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Telephone |
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 076846
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | 321688
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License Number State | NY
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