Provider Demographics
NPI:1760429724
Name:DOLAN, RORY O (MD)
Entity Type:Individual
Prefix:DR
First Name:RORY
Middle Name:O
Last Name:DOLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11 PLAZA ST W
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-3706
Mailing Address - Country:US
Mailing Address - Phone:718-638-2020
Mailing Address - Fax:718-230-3429
Practice Address - Street 1:11 PLAZA ST W
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-3706
Practice Address - Country:US
Practice Address - Phone:718-638-2020
Practice Address - Fax:718-230-3429
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106988207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00188050Medicaid
NY294452Medicare ID - Type Unspecified
NY00188050Medicaid