Provider Demographics
NPI:1598172777
Name:EMERHI, COLLINS O
Entity Type:Individual
Prefix:
First Name:COLLINS
Middle Name:O
Last Name:EMERHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 EVERGREEN AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:AUBURNDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02466-1703
Mailing Address - Country:US
Mailing Address - Phone:617-792-0500
Mailing Address - Fax:
Practice Address - Street 1:73 LEXINGTON ST
Practice Address - Street 2:LL5
Practice Address - City:AUBURNDALE
Practice Address - State:MA
Practice Address - Zip Code:02466-1356
Practice Address - Country:US
Practice Address - Phone:617-792-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-19
Last Update Date:2014-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAT3LV251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health