Individual
MICHELE T MCCOLLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
506 MALCOLM X BLVD, NEW YORK, NY 10037-1802
(212) 939-2250
Mailing address
10910 201ST ST, SAINT ALBANS, NY 11412-1314
(718) 740-6887
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
009227
NY
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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