Jacqueline Sommer Colalillo

NPI #1104701671 in Lake Grove, New York

Provider Information

NPI Number
1104701671
Entity Type
Individual
Name
Jacqueline Sommer Colalillo
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Physician Assistant
Enumeration Date
Aug 6, 2025
Last Updated
Aug 25, 2025

Practice Location

Address
4 SMITH HAVEN MALL STE 110
ZIP Code
11755-1219
Phone
(631) 444-6270

Specialties & Taxonomy Codes

Specialty
Physician Assistant

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