Provider Demographics
NPI:1730595182
Name:COLLECTIVE PRIMARY CARE MANHATTAN
Entity type:Organization
Organization Name:COLLECTIVE PRIMARY CARE MANHATTAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-454-4672
Mailing Address - Street 1:101 TREMONT ST FL 6
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02108-5004
Mailing Address - Country:US
Mailing Address - Phone:617-804-5981
Mailing Address - Fax:
Practice Address - Street 1:80 MAIDEN LN
Practice Address - Street 2:21ST FLOOR, SUITE 2101
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4811
Practice Address - Country:US
Practice Address - Phone:617-454-4672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-07
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty