Provider Demographics
NPI:1023081684
Name:COLLINI, FRANCIS JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:JOSEPH
Last Name:COLLINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:SHAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18708-1482
Mailing Address - Country:US
Mailing Address - Phone:570-674-6525
Mailing Address - Fax:570-674-6520
Practice Address - Street 1:1845 MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:SHAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18708-1482
Practice Address - Country:US
Practice Address - Phone:570-674-6525
Practice Address - Fax:570-674-6520
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044972E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01458571Medicaid
PA01458571Medicaid
PACO580391Medicare ID - Type Unspecified