Provider Demographics
NPI:1417690785
Name:ERNSTE-MCDOWELL, COLLIN PERRY (RN)
Entity Type:Individual
Prefix:
First Name:COLLIN
Middle Name:PERRY
Last Name:ERNSTE-MCDOWELL
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:COLLIN
Other - Middle Name:PERRY
Other - Last Name:MCDOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:111 WADSWORTH AVE APT 17E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-6116
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 E 59TH ST RM 8B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1359
Practice Address - Country:US
Practice Address - Phone:212-434-4972
Practice Address - Fax:212-434-4974
Is Sole Proprietor?:No
Enumeration Date:2022-04-15
Last Update Date:2022-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY834910163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse