MEDICARE: DAWN M DOLAN RPA-C

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
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	010607-1	NY
2	363A00000X	Physician Assistant	010607	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871549048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN M DOLAN RPA-C

Provider Business Mailing Address
First Line	:	1416 SWEET HOME RD
Second Line	:	SUITE # 12
City	:	AMHERST
State	:	NY
Zip	:	14228-2784
Country	:	US
Telephone Number	:	716-636-7800
Fax Number	:

Provider Business Practice Location Address
First Line	:	1416 SWEET HOME RD
Second Line	:	SUITE # 12
City	:	AMHERST
State	:	NY
Zip	:	14228-2784
Country	:	US
Telephone Number	:	716-636-7800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	01/05/2009

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