Provider Demographics
NPI:1740083864
Name:COLOFIORE, MARY THERESA
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:THERESA
Last Name:COLOFIORE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 CHILDS RD E
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-4309
Mailing Address - Country:US
Mailing Address - Phone:402-680-7515
Mailing Address - Fax:
Practice Address - Street 1:2011 CHILDS RD E
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-4309
Practice Address - Country:US
Practice Address - Phone:402-680-7515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant