Healthcare Provider Details

I. General information

NPI: 1063666493
Provider Name (Legal Business Name): APARNA DOLE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2008
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 55TH ST STE 2950
BROOKLYN NY
11220
US

IV. Provider business mailing address

150 55TH ST STE 2950
BROOKLYN NY
11220-2508
US

V. Phone/Fax

Practice location:
  • Phone: 718-630-6557
  • Fax:
Mailing address:
  • Phone: 718-630-6557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME108168
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number289051
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: