Collymore, David C

Collymore, David C is an individual health care provider with primary practice located at 1776 Clay Ave , Bronx NY 10457-7239. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Collymore, David C can be contacted via phone (718) 299-1100.

Contact Information

Primary practice address
1776 Clay Ave Bronx NY 10457-7239
Phone: (718) 299-1100
Fax: (718) 299-4633
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 225742 New York

Profile Details

NPI number 1023000353
LBN Legal business name Collymore, David C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2005
Last updated Jan 30th, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023000353 NPPES
New York MEDICAID 00665274

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