| Neal T. Smith & Jeannine L. Dolan, M.d.'s | |
|
5973 Walworth Road Ontario NY 14519 | |
| (315) 524-2881 | |
| (315) 524-2231 |
| Full Name | Neal T. Smith & Jeannine L. Dolan, M.d.'s |
|---|---|
| Speciality | Family Medicine |
| Location | 5973 Walworth Road, Ontario, New York |
| Authorized Official Name and Position | Neal T. Smith (PARTNER) |
| Authorized Official Contact | 3155242881 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neal T. Smith & Jeannine L. Dolan, M.d.'s P.o. Box 368 Ontario NY 14519 Ph: (315) 524-2881 | Neal T. Smith & Jeannine L. Dolan, M.d.'s 5973 Walworth Road Ontario NY 14519 Ph: (315) 524-2881 |
| NPI Number | 1205923232 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 07/30/2020 |
| Medicare PECOS PAC ID | 0244203842 |
|---|---|
| Medicare Enrollment ID | O20040812001253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205923232 | NPI | - | NPPES |
| CF6398 | Other | NY | RAILROAD MEDICARE PTAN (PIN) |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jeannine L Dolan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689761454 PECOS PAC ID: 8820006091 Enrollment ID: I20110131000260 |
| Provider Name | Neal T Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588751515 PECOS PAC ID: 2769455377 Enrollment ID: I20110131000317 |