Provider Demographics
NPI:1487811121
Name:COLLIER, TRENTON (MD)
Entity type:Individual
Prefix:DR
First Name:TRENTON
Middle Name:
Last Name:COLLIER
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:PO BOX 5907
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-5907
Mailing Address - Country:US
Mailing Address - Phone:646-962-5665
Mailing Address - Fax:
Practice Address - Street 1:156 WILLIAM ST FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-5358
Practice Address - Country:US
Practice Address - Phone:646-962-5665
Practice Address - Fax:646-962-5687
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2447207R00000X
390200000X
NY248775207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2023764-01Medicaid
TX8W6732OtherBCBSTX
TX2023764-01Medicaid