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NPI Code Detail

MEDICARE: JOHN MCCOLLUM RN

MEDICARE:   JOHN  MCCOLLUM  RN
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
1363LA2200XAdult Health Nurse Practitioner312846NY
2163WS0121XPlastic Surgery Registered Nurse850445NY

General Provider Information

NPI Number : 1760262448
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN MCCOLLUM RN
Provider Business Mailing Address
First Line : 1100 PARK AVE # 1B
Second Line :
City : NEW YORK
State : NY
Zip : 10128-1202
Country : US
Telephone Number : 212-920-6800
Fax Number : 212-920-6249
Provider Business Practice Location Address
First Line : 1100 PARK AVE # 1B
Second Line :
City : NEW YORK
State : NY
Zip : 10128-1202
Country : US
Telephone Number : 212-920-6800
Fax Number : 212-920-6249
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2023
Last Update Date : 06/03/2026

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