Provider Demographics
NPI:1144426602
Name:WILLIAM R. COLLINI, M.D., P.A.
Entity Type:Organization
Organization Name:WILLIAM R. COLLINI, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:COLLINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-383-9898
Mailing Address - Street 1:181 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-1020
Mailing Address - Country:US
Mailing Address - Phone:973-383-9898
Mailing Address - Fax:973-383-9665
Practice Address - Street 1:181 HIGH ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-1020
Practice Address - Country:US
Practice Address - Phone:973-383-9898
Practice Address - Fax:973-383-9665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA025446700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1922008036OtherTYPE 1 NPI
NJ1922008036OtherTYPE 1 NPI
NJ017604Medicare ID - Type Unspecified