Healthcare Provider Details

I. General information

NPI: 1841227352
Provider Name (Legal Business Name): JOHN C KOLLAR DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 01/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

449B MARKET ST
SADDLE BROOK NJ
07663-5941
US

IV. Provider business mailing address

449B MARKET ST
SADDLE BROOK NJ
07663-5941
US

V. Phone/Fax

Practice location:
  • Phone: 201-712-7900
  • Fax: 201-712-7902
Mailing address:
  • Phone: 201-712-7900
  • Fax: 201-712-7902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMB52216
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: