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EDGAR COLLAZO M.D. NPI 1073596169


NPI Information

NPI: 1073596169
Provider Name: EDGAR COLLAZO, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual
Organization: PM PEDIATRICS OF LIVINGSTON PLLC

PECOS Registration: Yes

Address:
452 W ALLEGHENY AVE
PHILADELPHIA, PA
ZIP 19133
Phone: (215) 291-2500
Get Directions

Edgar Collazo, M.D. is a pediatrics in Philadelphia, PA with 27 years of experience. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Edgar Collazo, M.D. NPI is 1073596169. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1997

The provider's business location address is:

452 W ALLEGHENY AVE
PHILADELPHIA, PA
ZIP 19133-639
Phone: (215) 291-2500
Fax: (215) 291-2587

The NPI 1073596169 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/22/2005 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsMD070294LPENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1037967MEDICARE ID-TYPE UNSPECIFIEDPENNSYLVANIA
20018164480001MEDICAIDPENNSYLVANIA
3H16004MEDICARE UPINPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.