Individual
MR. COLLIS JEREMY WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SPECIALIST
Contact information
Practice address
1275 E 84TH ST, BROOKLYN, NY 11236-4911
(347) 873-2161
Mailing address
1275 E 84TH ST, BROOKLYN, NY 11236-4911
(347) 873-2161
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2022342261
NY
Other
Enumeration date
04/21/2026
Last updated
04/21/2026
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