Doctor Name: | KIM ANN DOLAN |
NPI Number: | 1063669455 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | F401171-1 |
Business Practice Address: | 351 Rifle Camp Rd West Paterson, NJ - 074242726 |
Business Phone Number: | 9733450644 |
Business Fax Number: | |
Mailing Address: | 351 Rifle Camp Rd, WEST PATERSON |
State: | NJ |
Postal Code: | 074242726 |
Phone Number: | 9733450644 |
Fax Number: | |
NPI Enumeration Date: | 08/27/2008 |
NPI Last Update Date: | 08/27/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | F401171-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |