Provider Demographics
NPI:1386208544
Name:COLOSIMO, KAREN ELIZABETH
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ELIZABETH
Last Name:COLOSIMO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 ALBERTA DR STE 110
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1813
Mailing Address - Country:US
Mailing Address - Phone:716-204-5925
Mailing Address - Fax:
Practice Address - Street 1:331 ALBERTA DR STE 110
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1813
Practice Address - Country:US
Practice Address - Phone:716-204-5925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency