Individual
JESSICA COLLAZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2811 QUEENS PLZ N FL 5, LONG ISLAND CITY, NY 11101-4172
(718) 391-8300
Mailing address
1524 GLOVER ST, BRONX, NY 10462-4930
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
976685
NY
Other
Enumeration date
12/08/2025
Last updated
12/08/2025
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