Provider Demographics
NPI:1639377419
Name:POMARO, COLLEEN JOYCE (CNP)
Entity Type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:JOYCE
Last Name:POMARO
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WILDA AVENUE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-2921
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3921 EAST MARKET ST
Practice Address - Street 2:NORTHMAR III PAUL M ROSMAN DO
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484
Practice Address - Country:US
Practice Address - Phone:330-856-3104
Practice Address - Fax:330-856-3056
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN123065163W00000X
OHNP07679363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse