Provider Demographics
NPI:1316161896
Name:COLBY, HEATHER MARY (PA)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:MARY
Last Name:COLBY
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Gender:F
Credentials:PA
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Mailing Address - Street 1:5 E 98TH ST
Mailing Address - Street 2:BOX 1174
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6501
Mailing Address - Country:US
Mailing Address - Phone:212-241-2232
Mailing Address - Fax:212-241-3023
Practice Address - Street 1:5 E 98TH ST
Practice Address - Street 2:BOX 1174
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6501
Practice Address - Country:US
Practice Address - Phone:212-241-2232
Practice Address - Fax:212-241-3023
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2010-11-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY011574363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant