Russo-Colt, Mary Bertha

Russo-Colt, Mary Bertha is an individual health care provider with primary practice located at 3406 Peach St , Erie PA 16508-2740. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Russo-Colt, Mary Bertha can be contacted via phone (814) 877-5381.

Contact Information

Primary practice address
3406 Peach St Erie PA 16508-2740
Phone: (814) 877-5381
Fax: (814) 864-3471
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS006175L Pennsylvania

Profile Details

NPI number 1790780427
LBN Legal business name Russo-Colt, Mary Bertha
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated May 15th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790780427 NPPES
Pennsylvania Other 001168615 PA MEDICAID

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