Individual
LEWIS JOHN COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
450 CLARKSON AVE, BOX #30, BROOKLYN, NY 11203-2012
(718) 221-5215
Mailing address
450 CLARKSON AVE, BOX #30, BROOKLYN, NY 11203-2012
(718) 221-5215
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
521821
NJ
2255A2300X
Athletic Trainer
Primary
67001723
NY
Other
Enumeration date
12/04/2009
Last updated
12/04/2009
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