Provider Demographics
NPI:1821535964
Name:DUNBAR, HAILI (PA-C)
Entity Type:Individual
Prefix:
First Name:HAILI
Middle Name:
Last Name:DUNBAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 ADAMS ST UNIT 502
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-2027
Mailing Address - Country:US
Mailing Address - Phone:914-907-4379
Mailing Address - Fax:
Practice Address - Street 1:1690 CROWN COLONY DR
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-0913
Practice Address - Country:US
Practice Address - Phone:914-907-4379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-27
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA6074363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant