Provider Demographics
NPI:1619611449
Name:COLLINGS, KENDRA RAE
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:RAE
Last Name:COLLINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 EAGLES POINT CIR
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-3334
Mailing Address - Country:US
Mailing Address - Phone:315-857-5957
Mailing Address - Fax:
Practice Address - Street 1:1500 N JAMES ST
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-2844
Practice Address - Country:US
Practice Address - Phone:315-338-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic