MEDICARE: PATRICK COLLINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	138697	NY

General Provider Information

NPI Number	:	1073511424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK COLLINS

Provider Business Mailing Address
First Line	:	4171 DRIFTWOOD DR
Second Line	:
City	:	BEMUS POINT
State	:	NY
Zip	:	14712-9783
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17 SHERMAN ST
Second Line	:	SUITE 2100
City	:	JAMESTOWN
State	:	NY
Zip	:	14701-7080
Country	:	US
Telephone Number	:	716-664-2944
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	06/15/2021

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Directions to “ PATRICK COLLINS ” Practice Location

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