Provider Demographics
NPI:1649886615
Name:COLONNA, ELIZABETH (PT,DPT)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:COLONNA
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 ABERDEEN AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2456
Mailing Address - Country:US
Mailing Address - Phone:973-393-1521
Mailing Address - Fax:
Practice Address - Street 1:98 E 4TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-9001
Practice Address - Country:US
Practice Address - Phone:646-230-8190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0461522081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine