Basic Information
Provider Information
NPI: 1154354785
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADKINS
FirstName: DANA
MiddleName: EDWIN
NamePrefix: DR.
NameSuffix: JR.
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 19 BRADHURST AVE STE 3100N
Address2:  
City: HAWTHORNE
State: NY
PostalCode: 105322140
CountryCode: US
TelephoneNumber: 9149099018
FaxNumber: 9149099028
Practice Location
Address1: 100 WOODS RD
Address2:  
City: VALHALLA
State: NY
PostalCode: 105951530
CountryCode: US
TelephoneNumber: 9144932363
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/08/2006
LastUpdateDate: 12/18/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/18/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207T00000X307830NYY Allopathic & Osteopathic PhysiciansNeurological Surgery 
207T00000XMD038299DCN Allopathic & Osteopathic PhysiciansNeurological Surgery 
207PE0005X13279HIN Allopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric Medicine

No ID Information.


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