Healthcare Provider Details

I. General information

NPI: 1437147691
Provider Name (Legal Business Name): CATHERINE ATKINS PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 DAVIS AVE
NEPTUNE NJ
07753-4488
US

IV. Provider business mailing address

3600 ROUTE 66
NEPTUNE NJ
07753-2645
US

V. Phone/Fax

Practice location:
  • Phone: 732-776-4930
  • Fax:
Mailing address:
  • Phone: 732-807-0877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number35S100397300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: