Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 430906 | NY |
NPI | 1023497575 |
---|---|
Provider Name | Miss Ashlea Christa Colosimo |
First Address | Rochester, NY 14642 |
Second Address | Rochester, NY 14642 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2015 |
Last Update Date | 11/01/2016 |