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General NPI Number Information
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NPI Number | 1144451253
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Entity Type | Organization
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Legal Business Name | BETH A COLLINS MD, P.C.
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 02/22/2012
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Provider Practice Location Address
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Address Line | 2614 BOSTON POST RD SUITE 16C
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City | GUILFORD
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State | CT
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Zip | 06437-1369
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Country | US
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Telephone | 203-689-5295
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Fax | 203-689-5428
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Provider Business Mailing Address
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Address Line | 2614 BOSTON POST RD SUITE 16C
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City | GUILFORD
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State | CT
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Zip | 06437-1369
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Country | US
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Telephone | 203-689-5295
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Fax | 203-689-5428
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Authorized Official
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Title or Position | PRESIDENT
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Name | BETH ANN COLLINS
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Credential | M.D.
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Telephone | 404-374-2654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 047848
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License Number State | CT
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