Individual provider · Type 1 NPI

Jacqueline Sommer Colalillo

Physician Assistant · Lake Grove, NY

NPI number 1104701671 Active

Practice location

4 Smith Haven Mall Ste 110
Lake Grove, NY 11755-1219

Call (631) 444-6270 Map

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XNone listed

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1104701671

Jacqueline Sommer Colalillo's National Provider Identifier is 1104701671, issued on Aug 6, 2025. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Lake Grove, NY. The record was last updated on Aug 25, 2025.