Provider Demographics
NPI:1760900591
Name:COLANERI, CRISTA (ATC)
Entity Type:Individual
Prefix:
First Name:CRISTA
Middle Name:
Last Name:COLANERI
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1284 NEPTUNO CT SW
Mailing Address - Street 2:
Mailing Address - City:OCEAN ISLE BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28469-5455
Mailing Address - Country:US
Mailing Address - Phone:908-419-9036
Mailing Address - Fax:
Practice Address - Street 1:1284 NEPTUNO CT SW
Practice Address - Street 2:
Practice Address - City:OCEAN ISLE BEACH
Practice Address - State:NC
Practice Address - Zip Code:28469
Practice Address - Country:US
Practice Address - Phone:908-419-9036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer