Collazzo, Jack A.

Collazzo, Jack A. is an individual health care provider with primary practice located at 825 Old Lancaster Rd Suite 320, Bryn Mawr PA 19010-3231. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Collazzo, Jack A. can be contacted via phone (610) 527-3800.

Contact Information

Primary practice address
825 Old Lancaster Rd Suite 320 Bryn Mawr PA 19010-3231
Phone: (610) 527-3800
Fax: (610) 527-8805
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X MD052149-L Pennsylvania

Profile Details

NPI number 1891725891
LBN Legal business name Collazzo, Jack A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 4th, 2006
Last updated Apr 5th, 2017 - about 8 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 1891725891 NPPES
Pennsylvania MEDICAID 0015849150005

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