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General NPI Number Information
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NPI Number | 1083988281
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Entity Type | Organization
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Legal Business Name | MARGUERITE H. COLLINS M.D.
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Dates
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Enumeration Date | 03/06/2012
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Last Update Date | 03/06/2012
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Provider Practice Location Address
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Address Line | 271 BROADSTREET HOLLOW RD
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City | SHANDAKEN
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State | NY
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Zip | 12480-5305
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Country | US
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Telephone | 845-688-7558
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Fax | 845-688-2240
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Provider Business Mailing Address
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Address Line | 271 BROADSTREET HOLLOW RD
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City | SHANDAKEN
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State | NY
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Zip | 12480-5305
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Country | US
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Telephone | 845-688-7558
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Fax | 845-688-2240
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARGUERITE HELEN COLLINS
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Credential | M.D.
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Telephone | 845-688-7558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 167294
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License Number State | NY
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