Jose Luis Colon, M.S.,R.PH.
Individual provider Active NPI Pharmacist · Mohegan Lake, NY
NPI 1700054293 · NPPES record last updated Feb 19, 2008
Key facts
- NPI
- 1700054293
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 028644 (NY)
- Practice address
- 3105 E Main St
Mohegan Lake, NY 10547-1521 - Phone
- (914) 526-0240
- NPI assigned
- Feb 19, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science, Registered Pharmacist
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Great Atlantic & Pacific Tea Company Inc | Past | Accepting new patients | |
| Great Atlantic & Pacific Tea Company Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 028644 | NY | Yes |
Addresses
Primary practice location
3105 E Main St
Mohegan Lake, NY 10547-1521
Mailing address
3781 Oriole CT
Shrub Oak, NY 10588-1208
Phone (914) 243-6881
Other providers in Mohegan Lake, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.