Provider Demographics
NPI:1982905014
Name:WELCH, DOLORES ANN (ANP)
Entity Type:Individual
Prefix:
First Name:DOLORES
Middle Name:ANN
Last Name:WELCH
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 NORTHFIELD RD
Mailing Address - Street 2:NORTHFIELD FAMILY MEDICINE.PC
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2322
Mailing Address - Country:US
Mailing Address - Phone:631-724-2233
Mailing Address - Fax:631-724-4996
Practice Address - Street 1:236 NORTHFIELD RD
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2322
Practice Address - Country:US
Practice Address - Phone:631-724-2233
Practice Address - Fax:631-724-4996
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305219364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health