Healthcare Provider Details

I. General information

NPI: 1871549048
Provider Name (Legal Business Name): DAWN M DOLAN RPA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 01/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416 SWEET HOME RD SUITE # 12
AMHERST NY
14228-2784
US

IV. Provider business mailing address

1416 SWEET HOME RD SUITE # 12
AMHERST NY
14228-2784
US

V. Phone/Fax

Practice location:
  • Phone: 716-636-7800
  • Fax:
Mailing address:
  • Phone: 716-636-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number010607
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number010607-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: