Provider Demographics
NPI:1407146400
Name:COLLINS, MELINDA JEAN (DO)
Entity Type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:JEAN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 OVERLOOK AVE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2206
Mailing Address - Country:US
Mailing Address - Phone:201-489-5999
Mailing Address - Fax:201-489-1898
Practice Address - Street 1:150 OVERLOOK AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2206
Practice Address - Country:US
Practice Address - Phone:201-489-5999
Practice Address - Fax:201-489-1898
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09908000207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology