Provider Demographics
NPI:1730789165
Name:COLLEGIATE HEALTH SERVICES LLP
Entity type:Organization
Organization Name:COLLEGIATE HEALTH SERVICES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMIERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-335-5140
Mailing Address - Street 1:2 CHASER CT
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-2933
Mailing Address - Country:US
Mailing Address - Phone:646-335-5140
Mailing Address - Fax:
Practice Address - Street 1:2 CHASER CT
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-2933
Practice Address - Country:US
Practice Address - Phone:646-335-5140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty