Provider Demographics
NPI:1295722601
Name:KOLLMEIER, BRETT ROLAND (MD)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:ROLAND
Last Name:KOLLMEIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 BIRCH AVE
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-7428
Mailing Address - Country:US
Mailing Address - Phone:215-428-1021
Mailing Address - Fax:
Practice Address - Street 1:1945 STATE ROUTE 33
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4859
Practice Address - Country:US
Practice Address - Phone:732-776-4945
Practice Address - Fax:732-776-4550
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07816100207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2K2874OtherHEALTHNET
NJ2371365000OtherAMERIHEALTH PRODUCTS
NJ0050245Medicaid
NJ2371365000OtherAMERIHEALTH PRODUCTS