Collazo, Edgar
Collazo, Edgar is an individual health care provider with primary practice located at 452 W Allegheny Ave , Philadelphia PA 19133-3639. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Collazo, Edgar can be contacted via phone (215) 291-2500.Contact Information
Primary practice address
452 W Allegheny Ave
Philadelphia PA 19133-3639
Phone: (215) 291-2500
Fax: (215) 291-2587
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD070294L | Pennsylvania |
Profile Details
| NPI number | 1073596169 |
|---|---|
| LBN Legal business name | Collazo, Edgar |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 22nd, 2005 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073596169 | NPPES |
| Pennsylvania | MEDICAID | 0018164480001 |
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