| Kolloori & Kolloori, Physicians, Llc | |
|
1800 Clove Rd Staten Island NY 10304-1616 | |
| (718) 273-2929 | |
| (718) 876-9179 |
| Full Name | Kolloori & Kolloori, Physicians, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1800 Clove Rd, Staten Island, New York |
| Authorized Official Name and Position | Benjamin Joe Kolloori (PRESIDENT) |
| Authorized Official Contact | 7182732929 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kolloori & Kolloori, Physicians, Llc 1800 Clove Rd Staten Island NY 10304-1616 Ph: (718) 273-2929 | Kolloori & Kolloori, Physicians, Llc 1800 Clove Rd Staten Island NY 10304-1616 Ph: (718) 273-2929 |
| NPI Number | 1275798167 |
|---|---|
| Provider Enumeration Date | 07/21/2008 |
| Last Update Date | 07/21/2008 |
| Medicare PECOS PAC ID | 8820003148 |
|---|---|
| Medicare Enrollment ID | O20060208000167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275798167 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 133887 (New York) | Primary |
| Provider Name | Benjamin J Kolloori |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235230251 PECOS PAC ID: 9638184955 Enrollment ID: I20060208000222 |
| Provider Name | Lucy S Kolloori |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114004272 PECOS PAC ID: 2466467782 Enrollment ID: I20060208000237 |
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