Individual provider · Type 1 NPI

Mark J. Colaneri, P.A.

Surgical Physician Assistant · Syracuse, NY

NPI number 1104883842 Active

Practice location

4900 Broad Rd
Syracuse, NY 13215-2265

Call (315) 251-3100 Map

Fax (315) 449-9923

Mailing address

5719 Widewaters Pkwy
Syracuse, NY 13214-1880

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X008743 (NY)

Surgical Physician Assistant: Definition to come...

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About NPI 1104883842

Mark J. Colaneri, P.A.'s National Provider Identifier is 1104883842, issued on Apr 27, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Syracuse, NY. The record was last updated on Jul 8, 2007.