Provider Demographics
NPI:1972702553
Name:DOLLEY, STEPHEN M (RPH, BCPP)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:M
Last Name:DOLLEY
Suffix:
Gender:M
Credentials:RPH, BCPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 SUNRISE RD
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-3314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:WESTBOROUGH STATE HOSPITAL DEPARTMENT OF PHARMACY
Practice Address - Street 2:288 LYMAN ST.
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581
Practice Address - Country:US
Practice Address - Phone:508-616-2867
Practice Address - Fax:508-616-2863
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA203681835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric