Provider Demographics
NPI:1033656624
Name:CALDERON-COLON, LAURA (FNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:CALDERON-COLON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:CALDERON-COLON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1148 EAST TREMONT
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-2626
Mailing Address - Country:US
Mailing Address - Phone:718-378-3438
Mailing Address - Fax:378-378-3431
Practice Address - Street 1:1148 EAST TREMONT
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-2626
Practice Address - Country:US
Practice Address - Phone:718-378-3438
Practice Address - Fax:378-378-3431
Is Sole Proprietor?:No
Enumeration Date:2017-01-20
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY650718163W00000X
NY343208363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse