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NPI Code Detail

MEDICARE: FREDERICK DOLAN APN

MEDICARE: FREDERICK DOLAN APN
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
1363LF0000XFamily Nurse Practitioner26NJ01229800NJ

General Provider Information

NPI Number : 1144986092
Entity Type Code : Individual
Provider Name (Legal Business Name) : FREDERICK DOLAN APN
Provider Business Mailing Address
First Line : 901 ERNSTON RD
Second Line :
City : SOUTH AMBOY
State : NJ
Zip : 08879-2000
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 901 ERNSTON RD
Second Line :
City : SOUTH AMBOY
State : NJ
Zip : 08879-2000
Country : US
Telephone Number : 732-585-1815
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2021
Last Update Date : 01/16/2022

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