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General NPI Number Information
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NPI Number | 1043848393
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Entity Type | Individual
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Provider Name | PETER GUSTAVE COLLIN MD
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Gender | Male
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Dates
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Enumeration Date | 03/31/2020
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 550 1ST AVE
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City | NEW YORK
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State | NY
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Zip | 10016-6402
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Country | US
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Telephone | 212-263-5506
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Fax |
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Provider Business Mailing Address
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Address Line | 1470 BEACON ST APT 65
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City | BROOKLINE
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State | MA
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Zip | 02446-2614
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Country | US
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Telephone | 631-514-9931
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 3013491
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 316700
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License Number State | NY
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