Provider Demographics
NPI:1801277108
Name:DOWLING, JOHN R (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:R
Last Name:DOWLING
Suffix:
Gender:M
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 1:25 HACKETT BLVD
Mailing Address - Street 2:MC 141
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3462
Mailing Address - Country:US
Mailing Address - Phone:518-262-5185
Mailing Address - Fax:518-262-6303
Practice Address - Street 1:3344 CHAMBERS RD STE 200
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845-1403
Practice Address - Country:US
Practice Address - Phone:607-795-5100
Practice Address - Fax:570-887-6823
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018690363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant