Healthcare Provider Details

I. General information

NPI: 1851196273
Provider Name (Legal Business Name): NOVLETTE ANTOINETTE ATKINSON NP ADULT HEALTH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 EXECUTIVE DR
PLAINVIEW NY
11803-1718
US

IV. Provider business mailing address

54 CARR LN
CORAM NY
11727-4060
US

V. Phone/Fax

Practice location:
  • Phone: 833-433-2273
  • Fax:
Mailing address:
  • Phone: 631-681-6953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF310313-01
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: