Provider Demographics
NPI:1114062122
Name:COLBERT, PATRICK JOSEPH (APRN, CS)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:JOSEPH
Last Name:COLBERT
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Gender:M
Credentials:APRN, CS
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Mailing Address - Street 1:1 W FOSTER ST
Mailing Address - Street 2:SUITE 213
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-3810
Mailing Address - Country:US
Mailing Address - Phone:781-662-1880
Mailing Address - Fax:781-662-1878
Practice Address - Street 1:1 W FOSTER ST
Practice Address - Street 2:SUITE 213
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3810
Practice Address - Country:US
Practice Address - Phone:781-662-1880
Practice Address - Fax:781-662-1878
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA161005364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health