Provider Demographics
NPI:1871549048
Name:DOLAN, DAWN M (RPA-C)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:M
Last Name:DOLAN
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 SWEET HOME RD
Mailing Address - Street 2:SUITE # 12
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2784
Mailing Address - Country:US
Mailing Address - Phone:716-636-7800
Mailing Address - Fax:
Practice Address - Street 1:1416 SWEET HOME RD
Practice Address - Street 2:SUITE # 12
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2784
Practice Address - Country:US
Practice Address - Phone:716-636-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010607-1207PE0004X
NY010607363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02702936Medicaid
NY02702936Medicaid
NYPA1039Medicare PIN