Provider Demographics
NPI:1487660817
Name:SCOLLAN, NEIL (MD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:
Last Name:SCOLLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 E MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450
Mailing Address - Country:US
Mailing Address - Phone:203-235-5445
Mailing Address - Fax:203-634-3985
Practice Address - Street 1:469 E MAIN STREET
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450
Practice Address - Country:US
Practice Address - Phone:203-235-5445
Practice Address - Fax:203-634-3985
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT023034207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine