MS. JEANETTE COLLAZO (NPI# 1336517978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336517978 |
| Entity Type | Individual |
| Full Name | MS. JEANETTE COLLAZO |
| Credential | R.N. |
| Practice Address |
569 Old Mountain Rd Port Jervis NY 12771-3262 |
| Practice Telephone | 8456729351 |
| Mailing Telephone | 8456729351 |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2015-09-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WI0500X |
Registered Nurse Specialization: Infusion Therapy |
529962 | NY | Nursing Service Providers |
| Street Address |
569 OLD MOUNTAIN RD |
| City | PORT JERVIS |
| State | NY |
| Zip Code | 12771-3262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164045571 | Mary Ann Ricci | Counselor | 155 West Main, Port Jervis, NY 12771 | 2020-05-20 |
| 1982236022 | Jylian Ann Jackson | Social Worker | 146 Pike Street Outpatient Clinic, Port Jervis, NY 12771 | 2020-02-06 |
| 1336605591 | Dominic James Costantino | Physical Therapist | 17 Franklin Street, Port Jervis, NY 12771 | 2019-02-13 |
| 1871011775 | Pamela Ann Gluck | Counselor | 17 Sussex Street, Port Jervis, NY 12771 | 2017-08-31 |
| 1891211868 | Jamie Muller | Home Health Aide | 12 Mt William St, Port Jervis, NY 12771 | 2017-08-21 |
| 1922456649 | Greenville Township Volunteer Ambulance Corps Inc | Ambulance | 1495 Greenville Turnpike, Port Jervis, NY 12771 | 2016-06-03 |
| 1659702363 | Agnes Timberger | Social Worker | 626 Eatontown Road, Port Jervis, NY 12771 | 2013-12-05 |
| 1962795708 | Olga I Murray | Registered Nurse | 125 E. Main St., Port Jervis, NY 12771 | 2011-05-26 |
| 1407089444 | Daniel David Gersten | Counselor | 17-19 Sussex Street, Port Jervis, NY 12771 | 2009-08-25 |
| 1447404736 | Ann Marie Brown | Counselor | 136 Jersey Avenue, Suite 1, Port Jervis, NY 12771 | 2008-11-13 |
| Find all providers in zip 12771 | ||||
| Taxonomy Code | 163WI0500X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Infusion Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487251898 | Joelle Amanda Busman | Registered Nurse | 25 Marget Ann Ln, Suffern, NY 10901-3314 | 2020-10-08 |
| 1386269751 | Melissa Odom | Registered Nurse | 975 Liberty Ave Apt 4a, Brooklyn, NY 11208-1978 | 2020-06-11 |
| 1255984613 | Raushanah A. Smith | Registered Nurse | 141 Madison St., #1, Brooklyn, NY 11216 | 2019-07-24 |
| 1629554837 | Amanda L Fredette | Registered Nurse | 600 Sprague Rd, Memphis, NY 13112-9743 | 2018-07-11 |
| 1699216986 | Michael Eastman | Registered Nurse | 6938a Thursby Ave, Arverne, NY 11692-1138 | 2017-03-20 |
| 1386921419 | Andrea Michele Chrissides | Registered Nurse | 42 Sterns Ct, Farmingdale, NY 11735-1972 | 2011-11-03 |
| 1063718666 | Helen Onyinyechi Iwu | Registered Nurse | 13212 159th St, Jamaica, NY 11434-2926 | 2011-01-31 |
| 1518135813 | Joy Evoh | Registered Nurse | 1400 Pelham Pkwy S Bldg 16, Bronx, NY 10461-1119 | 2008-02-20 |
| 1396351748 | Daniel Moldwin | Registered Nurse | 45 S Service Rd, Plainview, NY 11803-4100 | 2020-09-21 |
| 1871088559 | Mariela Letizia Deleon | Registered Nurse | 535 5th Ave, New York, NY 10017-3620 | 2018-06-26 |
| Find all providers with the same taxonomy | ||||
| City | PORT JERVIS |
| Zip Code | 12771 |
Please comment or provide details below to improve the information on MS. JEANETTE COLLAZO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.