Provider Demographics
NPI:1376298745
Name:COLLAZO, CHRISTINA (RN)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:
Last Name:COLLAZO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2266 1ST AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-5054
Mailing Address - Country:US
Mailing Address - Phone:646-867-5325
Mailing Address - Fax:
Practice Address - Street 1:2266 1ST AVE APT 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-5054
Practice Address - Country:US
Practice Address - Phone:646-867-5325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY525326163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse