Provider Demographics
NPI:1912188590
Name:DOOLEY, MICHAEL F (RPH)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:F
Last Name:DOOLEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8262 LOCUST ST.
Mailing Address - Street 2:PO BOX 385
Mailing Address - City:HARRISVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13648-0385
Mailing Address - Country:US
Mailing Address - Phone:315-543-2231
Mailing Address - Fax:
Practice Address - Street 1:8262 LOCUST ST
Practice Address - Street 2:
Practice Address - City:HARRISVILLE
Practice Address - State:NY
Practice Address - Zip Code:13648-0385
Practice Address - Country:US
Practice Address - Phone:315-543-2231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-24
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039517183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY039517OtherLICENSE