Provider Demographics
NPI:1316013923
Name:DOLSKY, ALEXANDER E (PT)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:E
Last Name:DOLSKY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 45 QUEENS BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375
Mailing Address - Country:US
Mailing Address - Phone:718-575-5100
Mailing Address - Fax:718-575-0609
Practice Address - Street 1:110 45 QUEENS BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:718-575-5100
Practice Address - Fax:718-575-0609
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY09321225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01751968Medicaid
R27967Medicare UPIN
01190Medicare ID - Type Unspecified