Provider Demographics
NPI:1598911950
Name:COLAROSSI, ANTHONY GEORGE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:GEORGE
Last Name:COLAROSSI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 OCEAN AVE
Mailing Address - Street 2:2F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3044
Mailing Address - Country:US
Mailing Address - Phone:718-382-6940
Mailing Address - Fax:
Practice Address - Street 1:2350 OCEAN AVE
Practice Address - Street 2:2F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3044
Practice Address - Country:US
Practice Address - Phone:718-382-6940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-16
Last Update Date:2008-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008786103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical