Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 240475 | NY |
NPI | 1063457349 |
---|---|
Provider Name | Radana Dooley |
First Address | Schenectady, NY 12308 |
Second Address | Schenectady, NY 12308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2006 |
Last Update Date | 04/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02777291 | (05) | NY |
I55867 | (02) | NY |