Basic Information
Provider Information
NPI: 1396049748
EntityType: 2
ReplacementNPI:  
OrganizationName: AILEEN COLUNIO NURSE PRACTITIONER IN COMMUNITY HEALTH PLLC
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Mailing Information
Address1: 908 NIAGARA FALLS BLVD
Address2: SUITE 208
City: NORTH TONAWANDA
State: NY
PostalCode: 141202019
CountryCode: US
TelephoneNumber: 7166923302
FaxNumber: 7163323525
Practice Location
Address1: 2977 WESTINGHOUSE RD
Address2:  
City: HORSEHEADS
State: NY
PostalCode: 148458120
CountryCode: US
TelephoneNumber: 6077383507
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/28/2010
LastUpdateDate: 02/03/2011
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AuthorizedOfficialLastName: COLUNIO
AuthorizedOfficialFirstName: AILEEN
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AuthorizedOfficialTitleorPosition: NURSE PRACTIONER/OWNER
AuthorizedOfficialTelephone: 6077383507
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: FNP-C
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LC1500X  Y193200000X MULTI-SPECIALTY GROUPPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health

No ID Information.


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