Provider Demographics
NPI:1104036342
Name:COLLINS, CLAIRE (NP)
Entity Type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 W 168TH ST
Mailing Address - Street 2:BOX 4
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3725
Mailing Address - Country:US
Mailing Address - Phone:212-342-5155
Mailing Address - Fax:
Practice Address - Street 1:222 ROUTE 59
Practice Address - Street 2:SUITE 302
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5204
Practice Address - Country:US
Practice Address - Phone:845-357-8660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333890363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily