Individual
MRS. BRENDA YVETTE COLLAZOS MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7206 NORTHERN BLVD FL 2, JACKSON HEIGHTS, NY 11372-1049
(866) 670-6824
Mailing address
3530 81ST ST APT 1R, JACKSON HEIGHTS, NY 11372-5032
(347) 813-8037
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
033600
NY
Other
Enumeration date
03/24/2025
Last updated
04/22/2025
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