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General NPI Number Information
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NPI Number | 1760987689
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Entity Type | Individual
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Provider Name | CHRISTOPHER RAYMOND KOLLER MD
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Gender | Male
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Dates
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Enumeration Date | 03/25/2018
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 1 METRO BLVD
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City | CLIFTON
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State | NJ
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Zip | 07014
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Country | US
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Telephone | 973-230-6666
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Fax | 973-230-6686
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Provider Business Mailing Address
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Address Line | 1004 KINGSWOOD DR APT A
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City | CHAPEL HILL
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State | NC
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Zip | 27517-9475
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Country | US
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Telephone | 919-451-7546
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | D0097858
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 25MA12793000
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License Number State | NJ
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