Individual provider · NPI-1
Ivan Derrick Atkins
Driver · Rochester, NY
NPI number1144979154
StatusActive
Last updated in NPPESMar 18, 2022
Details
- NPI
- 1144979154
- Entity type
- Individual (NPI-1)
- Name
- Ivan Derrick Atkins
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 18, 2022
- Certification date
- Mar 18, 2022
- Last updated
- Mar 18, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172A00000X | Driver | – | NY | Yes |
Practice location
50 Dodge StRochester, NY 14606-1523
Phone 585-576-0068
Mailing address
50 Dodge St Apt BRochester, NY 14606-1523
Phone 585-576-0068
Is something wrong?
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