Individual
MADELINE COLLAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
25 POCONO RD, DENVILLE, NJ 07834-2954
(973) 625-6000
Mailing address
PO BOX 26960, NEW YORK, NY 10087-6960
(201) 804-2800
(201) 804-8883
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
26NJ00362500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
89270
CRNA ID
NJ
Enumeration date
01/24/2012
Last updated
01/24/2012
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