Healthcare Provider Details

I. General information

NPI: 1629993449
Provider Name (Legal Business Name): JULIE ANNE DOLLY
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 OAK DR
HAMILTON NY
13346-1386
US

IV. Provider business mailing address

3848 WELLINGTON DR N
CAZENOVIA NY
13035-9432
US

V. Phone/Fax

Practice location:
  • Phone: 315-228-7750
  • Fax:
Mailing address:
  • Phone: 315-263-8479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1400X
TaxonomyCollege Health Registered Nurse
License Number673227
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: