Provider Demographics
NPI:1144355611
Name:DOLSKY, RICHARD LAURENCE (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LAURENCE
Last Name:DOLSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:645 ROBINSON LN
Mailing Address - Street 2:
Mailing Address - City:HAVERFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19041-1921
Mailing Address - Country:US
Mailing Address - Phone:610-896-5208
Mailing Address - Fax:610-896-5208
Practice Address - Street 1:645 ROBINSON LN
Practice Address - Street 2:
Practice Address - City:HAVERFORD
Practice Address - State:PA
Practice Address - Zip Code:19041-1921
Practice Address - Country:US
Practice Address - Phone:610-896-5208
Practice Address - Fax:610-896-5208
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-024914-E208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
B36874Medicare UPIN