Basic Information
| Provider Information | |||||||||
| NPI: | 1750571949 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOLINAK | ||||||||
| FirstName: | JOAN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 750 E ADAMS ST | ||||||||
| Address2: | |||||||||
| City: | SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 132102342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154641800 | ||||||||
| FaxNumber: | 3154640247 | ||||||||
| Practice Location | |||||||||
| Address1: | 750 E ADAMS ST | ||||||||
| Address2: | |||||||||
| City: | SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 132102342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154641800 | ||||||||
| FaxNumber: | 3154640247 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2007 | ||||||||
| LastUpdateDate: | 04/22/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0102X | 35.094129 | OH | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0127X | 35.094129 | OH | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 208600000X | 35.094129 | OH | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0102X | MD435756 | PA | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0102X | 45335 | TN | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 208600000X | 45335 | TN | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 266658 | NY | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0102X | 266658 | NY | Y | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0127X | 266658 | NY | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery |
ID Information
| ID | Type | State | Issuer | Description | 03495301 | 05 | NY | MEDICAID |