Provider Demographics
NPI:1568786358
Name:DOLSON, THERESA (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:
Last Name:DOLSON
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 EVENING STAR LN
Mailing Address - Street 2:
Mailing Address - City:WALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:12586-2257
Mailing Address - Country:US
Mailing Address - Phone:845-778-8598
Mailing Address - Fax:
Practice Address - Street 1:38 GRANT ST
Practice Address - Street 2:
Practice Address - City:WALDEN
Practice Address - State:NY
Practice Address - Zip Code:12586-1850
Practice Address - Country:US
Practice Address - Phone:917-414-3993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050310183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist