| 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  |