1689335606 NPI number — AISLINN DOLAN DPT

Table of content: AISLINN DOLAN DPT (NPI 1689335606)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689335606 NPI number — AISLINN DOLAN DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOLAN
Provider First Name:
AISLINN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689335606
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
438 PELLIS RD STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15601-7900
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-850-7587
Provider Business Mailing Address Fax Number:
724-850-8329

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1748 JANCEY ST STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15206-1100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-404-8234
Provider Business Practice Location Address Fax Number:
412-404-8489
Provider Enumeration Date:
01/03/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT029794 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)