MEDICARE: DR. JOSEPH GARY DOLINSKY PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TB0200X	Cognitive & Behavioral Psychologist	4071PR	MA
2	103TC0700X	Clinical Psychologist	4071PR	MA
3	103TC2200X	Clinical Child & Adolescent Psychologist	4071PR	MA
4	103TH0100X	Health Service Psychologist	4071PR	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1019320	OTHER	MA	BEACON HEALTH STRATEGIES
2	41909	OTHER	MA	UNITED BEHAVIORALHEALTH
3	WO4354	OTHER	MA	BLUE CROSS OF MASS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	184163	OTHER	MA	PHCS
6	A007792	OTHER	MA	VALUEOPTIONS
7	700-11701	OTHER	MA	BLUE CROSS ALABAMA
8	V3674	OTHER	MA	EMPIRE BLUE CROSS
9	1019320	OTHER	MA	FALLON COMMUNITY
10	329245	OTHER	MA	HARVARD PILGRIM HEALTH
11	5649584	OTHER	MA	AETNA/US HEALTHCARE
12	803200V9972100	OTHER	MA	VERIZON BLUE CROSS
13	170823	OTHER	MA	MAGELLAN/HMO BLUE

General Provider Information

NPI Number	:	1659352672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH GARY DOLINSKY PH.D.

Provider Business Mailing Address
First Line	:	161 S MAIN ST
Second Line	:	SUITE 309
City	:	MIDDLETON
State	:	MA
Zip	:	01949-2485
Country	:	US
Telephone Number	:	978-750-1990
Fax Number	:	978-739-4042

Provider Business Practice Location Address
First Line	:	161 S MAIN ST
Second Line	:	SUITE 309
City	:	MIDDLETON
State	:	MA
Zip	:	01949-2485
Country	:	US
Telephone Number	:	978-750-1990
Fax Number	:	978-739-4042

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	07/10/2007

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