Provider Demographics
NPI:1497077325
Name:KOLMAN, MICHAEL E (RPH)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:KOLMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BIANCA BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10918-1461
Mailing Address - Country:US
Mailing Address - Phone:845-610-3201
Mailing Address - Fax:
Practice Address - Street 1:374 WINDSOR HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:VAILS GATE
Practice Address - State:NY
Practice Address - Zip Code:12584
Practice Address - Country:US
Practice Address - Phone:845-561-1320
Practice Address - Fax:845-561-1986
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040894183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist