Glenn Nicholas Collazo, D.C.
Individual provider Active NPI Chiropractor · Park Ridge, NJ
NPI 1376513051 · NPPES record last updated Jul 5, 2011
Key facts
- NPI
- 1376513051
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 38MC00430900 (NJ)
- Practice address
- 12 Wortendyke Rd
Park Ridge, NJ 07656-2046 - Phone
- (201) 750-7246
- Fax
- (201) 497-6614
- NPI assigned
- Jan 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38MC00430900 | NJ | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38MC00430900 | NJ | Yes |
Addresses
Primary practice location
12 Wortendyke Rd
Park Ridge, NJ 07656-2046
Mailing address
12 Wortendyke Rd
Park Ridge, NJ 07656-2046
Phone (201) 750-7246
Other names
- Dr. Glenn Nicholas Collazo
Other providers in Park Ridge, NJ
- Cgganjhos LLC
- Children'S Aid and Family Services, Inc.
- Children'S Aid and Family Services, Inc.
- Dominique Clark
- Elana T Clark
- Curalta Medical LLC
- Curalta Medical LLC
- Michele S Cushing-Hennessy
- Brian T Denichilo
- Rupam Desai
All providers in Park Ridge, NJ · Chiropractor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 5, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.