Provider Demographics
NPI:1871584037
Name:DOLIN, DANIELE J (MD)
Entity type:Individual
Prefix:DR
First Name:DANIELE
Middle Name:J
Last Name:DOLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 EAST 19TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2604
Mailing Address - Country:US
Mailing Address - Phone:212-673-7300
Mailing Address - Fax:212-777-0097
Practice Address - Street 1:55 E 9TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6311
Practice Address - Country:US
Practice Address - Phone:212-673-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217326208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02519675Medicaid
39R611OtherBCBS
39R611OtherBCBS
I00191Medicare UPIN