Provider Demographics
NPI:1578791646
Name:COLON-ACEVEDO, BETSY GISSELLE (MD)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:GISSELLE
Last Name:COLON-ACEVEDO
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 1:9970 MOUNTAIN VIEW DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WEST MIFFLIN
Mailing Address - State:PA
Mailing Address - Zip Code:15122-2474
Mailing Address - Country:US
Mailing Address - Phone:412-653-3080
Mailing Address - Fax:412-650-8860
Practice Address - Street 1:9970 MOUNTAIN VIEW DR
Practice Address - Street 2:SUITE 200
Practice Address - City:WEST MIFFLIN
Practice Address - State:PA
Practice Address - Zip Code:15122-2474
Practice Address - Country:US
Practice Address - Phone:412-653-3080
Practice Address - Fax:412-650-8860
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD455108207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology