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NPI Code Detail

MEDICARE: COLLEEN AMATO MD

MEDICARE: COLLEEN AMATO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician194244NY

General Provider Information

NPI Number : 1417947698
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLLEEN AMATO MD
Provider Business Mailing Address
First Line : PO BOX 624
Second Line :
City : LATHAM
State : NY
Zip : 12110-0624
Country : US
Telephone Number : 518-786-1299
Fax Number : 518-786-1293
Provider Business Practice Location Address
First Line : 600 MCCLELLAN ST
Second Line :
City : SCHENECTADY
State : NY
Zip : 12304-1009
Country : US
Telephone Number : 518-347-5307
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2005
Last Update Date : 07/08/2007

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