Harry Collins, MD LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

MA32839 Issued in NJ

Legal business name

HARRY COLLINS, MD LLC

Practice address

1 Ethel Rd
Suite 107B
Edison, NJ 08817-2838

Phone

(732) 287-2020

Fax

(732) 287-2071

NPI assigned

Sep 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Harry Collins, MD

Title

Owner

Phone

(732) 287-2020

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317254400000",
    "number": "1104924455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ETHEL RD",
            "address_2": "SUITE 107B",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088172838",
            "telephone_number": "732-287-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ETHEL RD",
            "address_2": "SUITE 107B",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088172838",
            "telephone_number": "732-287-2020",
            "fax_number": "732-287-2071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRY COLLINS, MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-09-29",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "HARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-287-2020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NJ",
            "license": "MA32839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2305402",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL NUMBER",
            "identifier": "1922078377",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Edison, NJ
• Providers in Edison, NJ by specialty
• Primary Care Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.