MEDICARE: PIERRE COLLIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	177092-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134181282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PIERRE COLLIN M.D.

Provider Business Mailing Address
First Line	:	900 STRAIGHT PATH
Second Line	:
City	:	WEST BABYLON
State	:	NY
Zip	:	11704-3203
Country	:	US
Telephone Number	:	631-957-0066
Fax Number	:	631-957-2701

Provider Business Practice Location Address
First Line	:	900 STRAIGHT PATH
Second Line	:
City	:	WEST BABYLON
State	:	NY
Zip	:	11704-3203
Country	:	US
Telephone Number	:	631-957-0066
Fax Number	:	631-957-2701

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2006
Last Update Date	:	08/29/2011

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