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NPI Code Detail

MEDICARE: MR. MICHAEL J DOLAN O.D.

MEDICARE:  MR. MICHAEL J DOLAN  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristT005268NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
8410025041OTHERNYMEDICARE RAIL ROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110005268OTHERNYBCBS, BLUE CHOICE HMO
2110414OTHERNYEYEMED VISION
349847OTHERNYDAVIS VISION
4161457017OTHERNYUNITED HEALTH CARE
55076330OTHERNYAETNA
617009359OTHERNYBLUE CHOICE HMO EYEWEAR
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9161457017OTHERNYVISION SERVICE PLAN
10MD462WOTHERNYPREFERRED CARE

General Provider Information

NPI Number : 1013989292
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL J DOLAN O.D.
Provider Business Mailing Address
First Line : 4384 LAKEVILLE RD
Second Line :
City : GENESEO
State : NY
Zip : 14454-9761
Country : US
Telephone Number : 585-243-2020
Fax Number : 585-243-1372
Provider Business Practice Location Address
First Line : 4384 LAKEVILLE RD
Second Line :
City : GENESEO
State : NY
Zip : 14454-9761
Country : US
Telephone Number : 585-243-2020
Fax Number : 585-243-1372
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 06/25/2008

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Directions to “ MR. MICHAEL J DOLAN O.D.” Practice Location

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