Healthcare Provider Details

I. General information

NPI: 1487947255
Provider Name (Legal Business Name): SUMI DOLBEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2011
Last Update Date: 05/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 LANGLEY RD SUITE 300
NEWTON MA
02459-1972
US

IV. Provider business mailing address

20 RESEARCH PKWY
OLD SAYBROOK CT
06475-4214
US

V. Phone/Fax

Practice location:
  • Phone: 800-370-3651
  • Fax: 860-510-0020
Mailing address:
  • Phone: 800-370-3651
  • Fax: 860-510-0020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN276106
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: