Individual
MS. JEANETTE COLLAZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
569 OLD MOUNTAIN RD, PORT JERVIS, NY 12771-3262
(845) 672-9351
Mailing address
569 OLD MOUNTAIN RD, PORT JERVIS, NY 12771-3262
(845) 672-9351
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
Primary
529962
NY
Other
Enumeration date
09/14/2015
Last updated
09/14/2015
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