Provider Demographics
NPI:1447440078
Name:COLOMBERO, SUSAN J (LIC ACUPUNCTURIST)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:J
Last Name:COLOMBERO
Suffix:
Gender:F
Credentials:LIC ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 NEW ENGLAND EXECUTIVE PARK
Mailing Address - Street 2:RSM MCGLADRAY (PAUL GALLAGHER) STE 320
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-5010
Mailing Address - Country:US
Mailing Address - Phone:781-685-3506
Mailing Address - Fax:
Practice Address - Street 1:7 NEW ENGLAND EXECUTIVE PARK
Practice Address - Street 2:RSM MCGLADRAY (PAUL GALLAGHER) STE 320
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-5010
Practice Address - Country:US
Practice Address - Phone:781-685-3506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA219123171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist