Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 044231 | CT |
Y | 2080P0202X | Pediatric Cardiologist | 2567541 | NY |
NPI | 1023040326 |
---|---|
Provider Name | Michael T Colon |
First Address | Albany, NY 12208-1742 |
Second Address | Albany, NY 12208-1742 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 22/05/2014 |