EDGAR COLLAZO (NPI# 1073596169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073596169 |
| Entity Type | Individual |
| Full Name | EDGAR COLLAZO |
| Credential | M.D. |
| Practice Address |
452 W Allegheny Ave Philadelphia PA 19133-3639 |
| Practice Telephone | 2152912500 |
| Practice Fax Number | 2152912587 |
| Mailing Telephone | 2152912500 |
| Mailing Fax Number | 2152912587 |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | MD070294L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0018164480001 | 05 |
| Street Address |
452 W ALLEGHENY AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19133-3639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619950706 | Carlos L. Dore | Pediatrics | 452 W Allegheny Ave, Philadelphia, PA 19133-3639 | 2005-11-22 |
| 1881886067 | Marsha L. Johnson | Social Worker | 452 W Allegheny Ave, Philadelphia, PA 19133 | 2007-08-13 |
| 1174506935 | Santosh Gupta | Obstetrics & Gynecology | 452 W Allegheny Ave, Philadelphia, PA 19133-3639 | 2005-11-25 |
| 1013990928 | Nestor O. Madrinan | Family Medicine | 452 W Allegheny Ave, Philadelphia, PA 19133-3639 | 2005-11-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427525708 | Delia Maria Home Care Agency LLC | Home Health Aide | 2945-47 N. 5th Street, Philadelphia, PA 19133 | 2018-10-25 |
| 1215417738 | Ajaj Medical Equipment & Supplies | Durable Medical Equipment & Medical Supplies | 3116 North Front St, Philadelphia, PA 19133 | 2018-08-14 |
| 1730636101 | Martha Pinto | Registered Nurse | 412 W. Lehigh Avenue, Philadelphia, PA 19133 | 2016-09-02 |
| 1295105989 | Mariana Arguelles-alcazar | Technician, Other | 216 W. Somerset St, Esfuerzo Program, Philadelphia, PA 19133 | 2015-10-07 |
| 1750785457 | Cinthya M Gonzalez Reveron | Speech-Language Pathologist | 2215 N American Street, Philadelphia, PA 19133 | 2014-10-09 |
| 1306166434 | Roberto Hilario | Counselor | 29297 North 5th Street, Philadelphia, PA 19133 | 2010-06-11 |
| 1598919300 | Pan American Academy Charter School | Local Education Agency (LEA) | 126 West Dauphin Street, Philadelphia, PA 19133 | 2008-11-06 |
| 1518157114 | Jennifer Leah Hoffman | Registered Nurse | 452 W. Allegheny Ave, Philadelphia, PA 19133 | 2007-07-30 |
| 1245441534 | Mark D. Lyons | Physician Assistant | 452 W. Allegheny Ave., Phila., PA 19133 | 2007-05-25 |
| 1104037613 | Christian Santana | Dentist | 29 10 North 5th Street, Phila, PA 19133 | 2007-05-25 |
| Find all providers in zip 19133 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861036279 | Stc Pediatrics LLC | Pediatrics | 300 E Hunting Park Ave, Philadelphia, PA 19124-6018 | 2019-10-30 |
| 1447818729 | Elizabeth Edmondston Tarr | Pediatrics | 3401 Civic Center Blvd Fl 9nw55, Philadelphia, PA 19104-4319 | 2019-06-03 |
| 1245799337 | Jerry Martin Kaplan | Pediatrics | 2421 Fairmount Ave, Philadelphia, PA 19130-2517 | 2019-03-18 |
| 1992299861 | Gayathri Prabhakar | Pediatrics | 3401 Civic Center Blvd 9nw, Rm 55, Philadelphia, PA 19104-4319 | 2018-06-14 |
| 1992298004 | Daniel Rappoport | Pediatrics | 3401 Civic Center Boulevard, 9nw, Room 55, Philadelphia, PA 19104-4399 | 2018-06-13 |
| 1376069567 | Childrens Hospital of Philadelphia | Pediatrics | 3401 Civic Center Blvd Fl 4, Philadelphia, PA 19104-4319 | 2017-08-18 |
| 1558881581 | Isabel Cristina Castillo Hernandez | Pediatrics | 4500-10, Apt 201b, Philadelphia, PA 19124 | 2017-06-21 |
| 1891225694 | Joshua Hruby Sperling | Pediatrics | 3401 Civic Center Boulevard 9nw, Room 55, The Children's Hospital of Philadelphia, Philadelphia, PA 19104-4399 | 2017-06-14 |
| 1124558911 | Salvatore Charles Rametta | Pediatrics | 3401 Civic Center Boulevard Building 9nw Room 55, Children's Hospital of Philadelphia, Philadelphia, PA 19104 | 2017-06-14 |
| 1922536952 | Alyssa Coffin | Pediatrics | 3401 Civic Center Blvd Fl 9nw, Philadelphia, PA 19104-4319 | 2017-06-03 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19133 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.