Provider Demographics
NPI:1417025107
Name:COLLIER, VIRGINIA ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:ANNE
Last Name:COLLIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANNIE
Other - Middle Name:
Other - Last Name:COLLIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6 SCENIC DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10590-2605
Mailing Address - Country:US
Mailing Address - Phone:914-533-7389
Mailing Address - Fax:
Practice Address - Street 1:34 MAPLE ST
Practice Address - Street 2:NORWALK HOSPITAL EMERGENCY DEPARTMENT
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06856
Practice Address - Country:US
Practice Address - Phone:203-852-2281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223226207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02576185Medicaid
NYI20734Medicare UPIN
NY02576185Medicaid