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Individual

MR. ANTHONY R COLLICA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PMHNP

Contact information

Practice address
146 PIKE ST, PORT JERVIS, NY 12771-1808
(845) 858-1456
(845) 378-3283
Mailing address
17 WEST ST, GOSHEN, NY 10924-1853
(845) 645-2625
(949) 399-6005

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403616
NY

Other

Enumeration date
06/08/2021
Last updated
04/01/2026
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