Provider Demographics
NPI:1891102208
Name:DOLAN, HANNAH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:
Last Name:DOLAN
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 1:6856 GROVELAND HILL RD
Mailing Address - Street 2:
Mailing Address - City:GROVELAND
Mailing Address - State:NY
Mailing Address - Zip Code:14462-9512
Mailing Address - Country:US
Mailing Address - Phone:585-245-1766
Mailing Address - Fax:
Practice Address - Street 1:6856 GROVELAND HILL RD
Practice Address - Street 2:
Practice Address - City:GROVELAND
Practice Address - State:NY
Practice Address - Zip Code:14462-9512
Practice Address - Country:US
Practice Address - Phone:585-245-1766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017580363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant