=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497291744
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DOSTERT AND DOVE,LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/10/2017
-----------------------------------------------------
Last Update Date | 01/10/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 21 GLEN CT
-----------------------------------------------------
City | LYNN
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01905-1853
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-835-0324
-----------------------------------------------------
Fax | 651-855-5295
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 21 GLEN CT
-----------------------------------------------------
City | LYNN
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01905-1853
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-835-0324
-----------------------------------------------------
Fax | 651-855-5295
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-OWNER
-----------------------------------------------------
Name | MS. ELIZABETH ANN LOPILATO
-----------------------------------------------------
Credential | R.N.
-----------------------------------------------------
Telephone | 781-835-0324
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number | RN205227
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------