Provider Demographics
NPI:1447564620
Name:COLON, NYDIA YMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:NYDIA
Middle Name:YMAR
Last Name:COLON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1294 CALLE JUAN BAIZ
Mailing Address - Street 2:PARQUE DE LA VISTA II APT 137-D
Mailing Address - City:SAN JUAN
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00924
Mailing Address - Country:UM
Mailing Address - Phone:787-645-2393
Mailing Address - Fax:
Practice Address - Street 1:29 WASHINGTON STREET STE 703
Practice Address - Street 2:ASHFORD MEDICAL CENTER
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907
Practice Address - Country:US
Practice Address - Phone:787-725-9708
Practice Address - Fax:787-721-6995
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-30
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR18567208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics