Provider Demographics
NPI:1447792908
Name:COLLINS, HEATHER (NP)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:COLLINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:GIONESI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:200 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 278
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4235
Mailing Address - Country:US
Mailing Address - Phone:516-877-0977
Mailing Address - Fax:516-294-6861
Practice Address - Street 1:100 PORT WASHINGTON BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576
Practice Address - Country:US
Practice Address - Phone:516-390-9640
Practice Address - Fax:516-390-9650
Is Sole Proprietor?:No
Enumeration Date:2016-11-14
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307977363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health