MEDICARE: TERRENCE COLLINS

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1265362677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRENCE COLLINS

Provider Business Mailing Address
First Line	:	4165 GRACE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2015
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4165 GRACE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2015
Country	:	US
Telephone Number	:	917-698-4121
Fax Number	:

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

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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Directions to “ TERRENCE COLLINS ” Practice Location

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