| Doctor Name: | MS. JEANETTE COLLAZO |
| NPI Number: | 1336517978 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | 529962 |
| Business Practice Address: | 569 Old Mountain Rd Port Jervis, NY - 127713262 |
| Business Phone Number: | 8456729351 |
| Business Fax Number: | |
| Mailing Address: | 569 Old Mountain Rd, PORT JERVIS |
| State: | NY |
| Postal Code: | 127713262 |
| Phone Number: | 8456729351 |
| Fax Number: | |
| NPI Enumeration Date: | 09/14/2015 |
| NPI Last Update Date: | 09/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WI0500X |
| License Number: | 529962 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Infusion Therapy |
| Taxonomy Definition: | |