Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | MD057934L | PA |
NPI | 1013911528 |
---|---|
Provider Name | Lynn Ann Colaiacovo |
First Address | Hermitage, PA 16148-2536 |
Second Address | Hermitage, PA 16148-2536 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000160272 | MEDPLUS (01) | PA |
000000352669 | ANTHEM (01) | OH |
000662020 | HIGHMARK (01) | PA |
0016268820006 | (05) | PA |
101761 | UPMC (01) | PA |
1500331 | GATEWAY (01) | PA |
201894518 | TRICARE (01) | PA |
G51741 | (02) | PA |
P00204247 | RAILROAD MEDICARE (01) | GA |