Provider Demographics
NPI:1508864802
Name:DOLGOS, PAULA
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:DOLGOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10441 PERRY HWY
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9292
Mailing Address - Country:US
Mailing Address - Phone:724-940-4144
Mailing Address - Fax:724-940-4148
Practice Address - Street 1:33 NORTHGATE PLZ
Practice Address - Street 2:
Practice Address - City:HARMONY
Practice Address - State:PA
Practice Address - Zip Code:16037-9257
Practice Address - Country:US
Practice Address - Phone:724-452-1277
Practice Address - Fax:724-452-0756
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006026L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP91473Medicare UPIN
PA070575RK3Medicare ID - Type UnspecifiedMEDICARE