Provider Demographics
NPI:1558340679
Name:COLLINS, MARGUERITE HELEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGUERITE
Middle Name:HELEN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:271 BROADSTREET HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:SHANDAKEN
Mailing Address - State:NY
Mailing Address - Zip Code:12480-5305
Mailing Address - Country:US
Mailing Address - Phone:845-688-7558
Mailing Address - Fax:845-688-2240
Practice Address - Street 1:271 BROADSTREET HOLLOW RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NY
Practice Address - Zip Code:12452
Practice Address - Country:US
Practice Address - Phone:845-688-7558
Practice Address - Fax:845-688-2240
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY167294207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00979057Medicaid
NY00979057Medicaid
B97539Medicare UPIN