Provider Demographics
NPI:1730145343
Name:COLLINS, RICHARD L (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:425 ESSJAY RD
Mailing Address - Street 2:STE 170
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5782
Mailing Address - Country:US
Mailing Address - Phone:716-630-1219
Mailing Address - Fax:716-817-1726
Practice Address - Street 1:325 ESSJAY RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8243
Practice Address - Country:US
Practice Address - Phone:716-630-1018
Practice Address - Fax:716-250-5909
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY166736-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000502284001OtherHEALTH NOW
NY161000580OtherEMPIRE
NY00010034001OtherUNIVERA
NY0403963OtherIHA
NY161000580OtherNORTH AMERICAN PREFERRED
NY116736-9WOtherWORKERS COMPENSATION
NY00987531Medicaid
NY110102940OtherRR MEDICARE