Individual
DANIELLE KOLLMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
44 JERSEY ST, DEER PARK, NY 11729-2327
(631) 416-8457
Mailing address
44 JERSEY ST, DEER PARK, NY 11729-2327
(631) 416-8457
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
3253841
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3253841
—
NY
Enumeration date
06/11/2016
Last updated
06/11/2016
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