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General NPI Number Information
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NPI Number | 1215523741
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Entity Type | Individual
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Provider Name | CODY PAUL COLLINS PA-C
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Gender | Male
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Dates
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Enumeration Date | 12/18/2020
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 789 E LANCASTER AVE
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City | VILLANOVA
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State | PA
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Zip | 19085-1522
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Country | US
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Telephone | 215-503-9070
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Fax |
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Provider Business Mailing Address
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Address Line | 33 CENTRAL AVE
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City | OCEAN CITY
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State | NJ
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Zip | 08226-4327
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Country | US
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Telephone | 609-675-4322
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 25MP00775900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA062214
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License Number State | PA
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