Provider Demographics
NPI:1548594237
Name:ATKINSON, WINSTON (MD)
Entity Type:Individual
Prefix:DR
First Name:WINSTON
Middle Name:
Last Name:ATKINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2912 BRIGHTON 12TH ST
Mailing Address - Street 2:APT. 1B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4754
Mailing Address - Country:US
Mailing Address - Phone:718-332-0470
Mailing Address - Fax:
Practice Address - Street 1:2912 BRIGHTON 12TH ST
Practice Address - Street 2:APT. 1B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4754
Practice Address - Country:US
Practice Address - Phone:718-332-0470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153707207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY92A641Medicare PIN