Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 46TR00254200 | NJ |
NPI | 1013990696 |
---|---|
Provider Name | Patrick Joseph Dolan |
First Address | Morris Plains, NJ 07950-2035 |
Second Address | Dover, NJ 07801-1629 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2005 |
Last Update Date | 08/07/2007 |