Provider Demographics
NPI:1043301427
Name:KOLANO, ANNA (DO)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:KOLANO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:PROVIDER ENROLLMENT DEPT
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19732-0191
Mailing Address - Country:US
Mailing Address - Phone:302-651-6212
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:NEMOURS PEDIATRICS PEOPLES PLAZA
Practice Address - Street 2:1400 PEOPLES PLAZA SUITE 300
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5708
Practice Address - Country:US
Practice Address - Phone:302-836-7820
Practice Address - Fax:302-836-7826
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC20004788208000000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1592917Medicaid
NJ7003501Medicaid
VA6715265Medicaid
MD1270061Medicaid
PA1592917Medicaid
002429T34Medicare PIN