Provider Demographics
NPI:1497774970
Name:COLLINS, JANET M (NP)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:M
Last Name:COLLINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CENTRAL PARK W
Mailing Address - Street 2:SUITE 1 U
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7253
Mailing Address - Country:US
Mailing Address - Phone:212-245-2733
Mailing Address - Fax:212-928-1009
Practice Address - Street 1:25 CENTRAL PARK W
Practice Address - Street 2:SUITE 1 U
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7253
Practice Address - Country:US
Practice Address - Phone:212-245-2733
Practice Address - Fax:212-928-1009
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY400721-1363LP0808X
NJ26NJ00041000363LP0808X, 364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Not Answered364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NO10421900OtherRN LICENSE
NY498721OtherRN LICENSE
NJ26NJ00041000OtherAPRN LICENSE
NY400721OtherNP CERTIFICATION #
NY400721OtherNP CERTIFICATION #
NJ26NO10421900OtherRN LICENSE
NY2E8801Medicare ID - Type Unspecified