Provider Demographics
NPI:1811674146
Name:DOLAN, CRYSTEL NICOLE
Entity type:Individual
Prefix:MRS
First Name:CRYSTEL
Middle Name:NICOLE
Last Name:DOLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CRYSTEL
Other - Middle Name:NICOLE
Other - Last Name:CABRERA AGUIRRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13107 86TH RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-1929
Mailing Address - Country:US
Mailing Address - Phone:347-755-0097
Mailing Address - Fax:
Practice Address - Street 1:13107 86TH RD
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-1929
Practice Address - Country:US
Practice Address - Phone:347-755-0097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist