| Harry Collins, Md Llc | |
|
1 Ethel Rd Suite 107b Edison NJ 08817-2838 | |
| (732) 287-2020 | |
| (732) 287-2071 |
| Full Name | Harry Collins, Md Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 Ethel Rd, Edison, New Jersey |
| Authorized Official Name and Position | Harry Collins (OWNER) |
| Authorized Official Contact | 7322872020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harry Collins, Md Llc 1 Ethel Rd Suite 107b Edison NJ 08817-2838 Ph: (732) 287-2020 | Harry Collins, Md Llc 1 Ethel Rd Suite 107b Edison NJ 08817-2838 Ph: (732) 287-2020 |
| NPI Number | 1104924455 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 09/29/2011 |
| Medicare PECOS PAC ID | 8820094477 |
|---|---|
| Medicare Enrollment ID | O20061005000010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104924455 | NPI | - | NPPES |
| 2305402 | Medicaid | NJ | |
| 1922078377 | Other | NPI INDIVIDUAL NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MA32839 (New Jersey) | Primary |
| Provider Name | Harry Collins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922078377 PECOS PAC ID: 1759386501 Enrollment ID: I20060929000018 |
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