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NPI Code Detail

MEDICARE: DR. DOLAN POWER PHD

MEDICARE: DR. DOLAN POWER PHD
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
11041C0700XClinical Social Worker104387MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PO2738OTHERMABLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number : 1730230772
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOLAN POWER PHD
Provider Business Mailing Address
First Line : 22 HILLIARD ST
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-4972
Country : US
Telephone Number : 617-354-7209
Fax Number :
Provider Business Practice Location Address
First Line : 22 HILLIARD ST
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-4972
Country : US
Telephone Number : 617-354-7209
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2007
Last Update Date : 07/08/2007

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