Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207NS0135X | Procedural Dermatology | 267986 | NY |
N | 207Q00000X | Family Doctor | 60267986 | NY |
NPI | 1417206459 |
---|---|
Provider Name | Dr. Brett Marsh Dolgin |
First Address | Great Neck, NY 11021-3358 |
Second Address | Great Neck, NY 11021-3358 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2012 |
Last Update Date | 07/09/2016 |