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
- City
- Lake Grove
- State
- New York
- ZIP Code
- 11755-1219
- Phone
- (631) 444-6270
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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