Provider Demographics
NPI:1336579929
Name:MURARESKU, COLLEEN CLARKE (LCGC)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:CLARKE
Last Name:MURARESKU
Suffix:
Gender:F
Credentials:LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3615 CIVIC CENTER BLVD
Mailing Address - Street 2:ARC 1002A
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4318
Mailing Address - Country:US
Mailing Address - Phone:267-426-9921
Mailing Address - Fax:215-590-2241
Practice Address - Street 1:34TH STREET AND CIVIC CENTER BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4318
Practice Address - Country:US
Practice Address - Phone:267-426-9921
Practice Address - Fax:215-590-2241
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS