Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 310255 | NY |
NPI | 1285013623 |
---|---|
Provider Name | Michael Collins |
First Address | Rochester, NY 14642-0001 |
Second Address | Rochester, NY 14642-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2015 |
Last Update Date | 13/07/2021 |