Provider Demographics
NPI:1558707059
Name:COLON, MELVIN JR (PT)
Entity Type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:
Last Name:COLON
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 UNION AVE
Mailing Address - Street 2:SUITE K 2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-1739
Mailing Address - Country:US
Mailing Address - Phone:718-387-7420
Mailing Address - Fax:718-387-7421
Practice Address - Street 1:202 UNION AVE
Practice Address - Street 2:SUITE K 2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-1739
Practice Address - Country:US
Practice Address - Phone:718-387-7420
Practice Address - Fax:718-387-7421
Is Sole Proprietor?:No
Enumeration Date:2013-05-12
Last Update Date:2013-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033549-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist