Ja'Quan Dollard
Individual provider Active NPI Athletic Trainer · Newark, DE
NPI 1124855192 · NPPES record last updated Sep 16, 2024
Key facts
- NPI
- 1124855192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 236 Pavin CT
Newark, DE 19702-2393 - Phone
- (302) 415-1528
- NPI assigned
- Sep 16, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physical Therapist | 2251S0007X | |||
| Orthopedic Physical Therapist | 2251X0800X | |||
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
236 Pavin CT
Newark, DE 19702-2393
Mailing address
236 Pavin CT
Newark, DE 19702-2393
Phone (302) 415-1528
Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.