Provider Demographics
NPI:1508188699
Name:COLABELLO, ANN MARIE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ANN MARIE
Middle Name:
Last Name:COLABELLO
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:ANN MARIE
Other - Middle Name:
Other - Last Name:MENNELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:488 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11518-1208
Mailing Address - Country:US
Mailing Address - Phone:516-593-7452
Mailing Address - Fax:
Practice Address - Street 1:488 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518-1208
Practice Address - Country:US
Practice Address - Phone:516-593-7452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-17
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052764183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist