Provider Demographics
NPI:1093194904
Name:LITTLE, COLLEEN (DO)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:LITTLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:271 GROVE AVE STE E
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-1730
Mailing Address - Country:US
Mailing Address - Phone:973-559-3700
Mailing Address - Fax:833-484-1686
Practice Address - Street 1:72 HAMBURG TPKE STE B
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:NJ
Practice Address - Zip Code:07457-1158
Practice Address - Country:US
Practice Address - Phone:973-696-6687
Practice Address - Fax:833-488-1216
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB10911400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine