Provider Demographics
NPI:1356742654
Name:DOT CERTIFIED, LLC
Entity type:Organization
Organization Name:DOT CERTIFIED, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:NVAYO
Authorized Official - Last Name:NDONGWA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-C
Authorized Official - Phone:585-957-5070
Mailing Address - Street 1:PO BOX 16960
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-0960
Mailing Address - Country:US
Mailing Address - Phone:585-957-5070
Mailing Address - Fax:585-368-9986
Practice Address - Street 1:128 COUNTRY WOOD LNDG
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4408
Practice Address - Country:US
Practice Address - Phone:585-957-5070
Practice Address - Fax:585-368-9986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-06
Last Update Date:2014-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334735363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty