Provider Demographics
NPI:1174875454
Name:ATKINS, KYLE J
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:J
Last Name:ATKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1249 WOODBOURNE RD
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19057-1232
Mailing Address - Country:US
Mailing Address - Phone:215-946-7230
Mailing Address - Fax:215-946-8120
Practice Address - Street 1:1249 WOODBOURNE RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19057-1232
Practice Address - Country:US
Practice Address - Phone:215-946-7230
Practice Address - Fax:215-946-8120
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF03501237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist