MEDICARE: MRS. MARIA L COLON APN

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
1	363LA2200X	Adult Health Nurse Practitioner	26NJ00553100	NJ

General Provider Information

NPI Number	:	1821482639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA L COLON APN

Provider Business Mailing Address
First Line	:	68 PALMER DR
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-2661
Country	:	US
Telephone Number	:	973-341-4343
Fax Number	:

Provider Business Practice Location Address
First Line	:	68 PALMER DR
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-2661
Country	:	US
Telephone Number	:	973-341-4343
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2015
Last Update Date	:	03/19/2015

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