Healthcare Provider Details

I. General information

NPI: 1801033618
Provider Name (Legal Business Name): ROCHELLE L. COLLINS, D.O. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2009
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BESTOR LN
BLOOMFIELD CT
06002-2485
US

IV. Provider business mailing address

PO BOX 217
BLOOMFIELD CT
06002-0217
US

V. Phone/Fax

Practice location:
  • Phone: 860-206-2122
  • Fax: 860-243-3820
Mailing address:
  • Phone: 860-206-2122
  • Fax: 860-243-3820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number042735
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. ROCHELLE LANGFORD COLLINS
Title or Position: PHYSICIAN
Credential: D.O.
Phone: 860-206-2122