Provider Demographics
NPI:1457510687
Name:COLINA-BISCOTTO, JUNER MARIANELA (MD)
Entity Type:Individual
Prefix:
First Name:JUNER
Middle Name:MARIANELA
Last Name:COLINA-BISCOTTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 CROSS RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06385-1215
Mailing Address - Country:US
Mailing Address - Phone:860-444-1292
Mailing Address - Fax:860-444-1827
Practice Address - Street 1:174 CROSS RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-1215
Practice Address - Country:US
Practice Address - Phone:860-444-1292
Practice Address - Fax:860-444-1292
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT51196207WX0107X
CT051196207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology