Healthcare Provider Details

I. General information

NPI: 1023081684
Provider Name (Legal Business Name): FRANCIS JOSEPH COLLINI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 05/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 MEMORIAL HWY
SHAVERTOWN PA
18708-1482
US

IV. Provider business mailing address

1845 MEMORIAL HWY
SHAVERTOWN PA
18708-1482
US

V. Phone/Fax

Practice location:
  • Phone: 570-674-6525
  • Fax: 570-674-6520
Mailing address:
  • Phone: 570-674-6525
  • Fax: 570-674-6520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD044972E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: