Provider Demographics
NPI:1124408968
Name:COLLADO, SUJENING I (MS)
Entity Type:Individual
Prefix:MISS
First Name:SUJENING
Middle Name:
Last Name:COLLADO
Suffix:I
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 WHITE PLAINS RD
Mailing Address - Street 2:5G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-2635
Mailing Address - Country:US
Mailing Address - Phone:646-884-1353
Mailing Address - Fax:
Practice Address - Street 1:755 WHITE PLAINS RD
Practice Address - Street 2:5G
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-2635
Practice Address - Country:US
Practice Address - Phone:646-884-1353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-07
Last Update Date:2015-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist