Individual
DR. EILEEN FRANCES COLLIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
53 GIBSON ROAD, GOSHEN, NY 10924
(845) 291-0100
(845) 343-5390
Mailing address
PO BOX 987, 21 ORCHARD STREET, MIDDLETOWN, NY 10940-5004
(845) 343-7614
(845) 343-5390
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125788
NY
207RG0100X
Gastroenterology Physician
125788
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00399284
—
NY
01
—
10507901
CAQH PROVIDER ID #
NY
01
—
125788
MEDICAL LICENSE
NY
01
—
1306096318
GROUP ORGANIZATION NPI
—
01
—
25MA0414310
MEDICAL LICENSE
NJ
01
—
SERIAL # 001120
USCG CERTIFICATE OF REGISTRY - MEDICAL DOCTOR
—
Enumeration date
09/27/2005
Last updated
03/07/2023
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