Provider Demographics
NPI:1871040899
Name:DOWLING, JANE ANN
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:ANN
Last Name:DOWLING
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 1:4005 W GILGO BCH
Mailing Address - Street 2:
Mailing Address - City:WEST GILGO BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11702-4615
Mailing Address - Country:US
Mailing Address - Phone:631-785-1226
Mailing Address - Fax:
Practice Address - Street 1:300 GARDEN CITY PLZ
Practice Address - Street 2:SUITE 350
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-3302
Practice Address - Country:US
Practice Address - Phone:516-747-9030
Practice Address - Fax:516-877-0998
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225749174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist