Provider Demographics
NPI:1417102047
Name:COLON, AIDA I (OTD/OTR/L,MS,BS)
Entity Type:Individual
Prefix:
First Name:AIDA
Middle Name:I
Last Name:COLON
Suffix:
Gender:F
Credentials:OTD/OTR/L,MS,BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 MAIN ST
Mailing Address - Street 2:AXIOM PT & OT PLUS, PLLC-SUITE 202
Mailing Address - City:TUCKAHOE
Mailing Address - State:NY
Mailing Address - Zip Code:10707-2948
Mailing Address - Country:US
Mailing Address - Phone:914-961-1010
Mailing Address - Fax:914-961-1011
Practice Address - Street 1:115 MAIN ST
Practice Address - Street 2:AXIOM PT & OT PLUS, PLLC-SUITE 202
Practice Address - City:TUCKAHOE
Practice Address - State:NY
Practice Address - Zip Code:10707-2948
Practice Address - Country:US
Practice Address - Phone:914-961-1010
Practice Address - Fax:914-961-1011
Is Sole Proprietor?:No
Enumeration Date:2008-11-24
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015130225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPENDINGOtherMVP HEALTHCARE
NYPENDINGOtherAETNA
NYPENDINGOtherHUDSON HEALTH
NYPENDINGOtherOPTUM PHYSICAL THERAPY
NYPENDINGOtherHUMANA
NYPENDINGOtherEMBLEUM HEALTH
NYPEMDINGOtherEMPIRE BLUE CROSS
NYPENDINGOtherAFFINITY HEALTH PLAN
NYPENDINGOtherHEALTH FIRST
NYPENDINGMedicaid
NYPEMDINGMedicare PIN