Provider Demographics
NPI:1154902260
Name:COLON-GONZALEZ, ERIC MICHAEL (DC)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:MICHAEL
Last Name:COLON-GONZALEZ
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1761 FIX RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-2850
Mailing Address - Country:US
Mailing Address - Phone:716-823-1343
Mailing Address - Fax:
Practice Address - Street 1:3270 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-1334
Practice Address - Country:US
Practice Address - Phone:716-599-1119
Practice Address - Fax:716-599-1120
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX013468-01111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor