Provider Demographics
NPI:1710156070
Name:DOOLING, DORA LEIGH (RN)
Entity Type:Individual
Prefix:MS
First Name:DORA
Middle Name:LEIGH
Last Name:DOOLING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HENMOND BLVD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-2524
Mailing Address - Country:US
Mailing Address - Phone:845-264-5293
Mailing Address - Fax:
Practice Address - Street 1:11 HENMOND BLVD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-2524
Practice Address - Country:US
Practice Address - Phone:845-264-5293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY507977-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY09202752Medicaid