Provider Demographics
NPI:1679865935
Name:KOLLISCH-SINGULE, MICHAELA CHRISTINA (MD)
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:CHRISTINA
Last Name:KOLLISCH-SINGULE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:251 SALINA MEADOWS PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-4516
Mailing Address - Country:US
Mailing Address - Phone:315-464-2000
Mailing Address - Fax:
Practice Address - Street 1:725 IRVING AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-464-2878
Practice Address - Fax:315-464-2879
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2020-09-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2681412086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery