Provider Demographics
NPI:1487647392
Name:COLUNIO, AILEEN S (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:AILEEN
Middle Name:S
Last Name:COLUNIO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2977 WESTINGHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845-8120
Mailing Address - Country:US
Mailing Address - Phone:607-846-2199
Mailing Address - Fax:607-846-2020
Practice Address - Street 1:2977 WESTINGHOUSE RD
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845-8120
Practice Address - Country:US
Practice Address - Phone:607-846-2199
Practice Address - Fax:607-846-2020
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3200391163W00000X
PASP009001363L00000X
NY289746363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACC9269OtherRR MEDICARE GROUP
NY02743171Medicaid
PAGU039832OtherMEDICARE GROUP
PAP00299300OtherRR MEDICARE PIN
PAGU039832OtherMEDICARE GROUP
NY02743171Medicaid