Provider Demographics
NPI:1326785510
Name:COLON, ROSEMARIE (SLP)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:
Last Name:COLON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 E MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-2668
Mailing Address - Country:US
Mailing Address - Phone:631-538-0579
Mailing Address - Fax:631-881-4413
Practice Address - Street 1:524 E MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2668
Practice Address - Country:US
Practice Address - Phone:631-538-0579
Practice Address - Fax:631-881-4413
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist