Provider Demographics
NPI:1659195956
Name:COLLINS, MARISA CONSTANCE WALSH
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:CONSTANCE WALSH
Last Name:COLLINS
Suffix:
Gender:U
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 CENTRAL PARK W APT 8A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-4118
Mailing Address - Country:US
Mailing Address - Phone:617-694-5342
Mailing Address - Fax:
Practice Address - Street 1:251 CENTRAL PARK W APT 8A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-4118
Practice Address - Country:US
Practice Address - Phone:617-694-5342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula