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Individual

DR. MICHELLE DENISE COLLINS-OGLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 741-2450
(718) 654-6692
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 741-2450

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
200000753
NC
208000000X
Pediatrics Physician
295923
NY
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
295923
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
891281Y
NC
Enumeration date
02/25/2007
Last updated
10/21/2019
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