Provider Demographics
NPI:1104881770
Name:WARSAW OB GYN PC
Entity type:Organization
Organization Name:WARSAW OB GYN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:THERESITA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOLOJAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-786-2219
Mailing Address - Street 1:408 NORTH MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NY
Mailing Address - Zip Code:14569
Mailing Address - Country:US
Mailing Address - Phone:585-786-2219
Mailing Address - Fax:585-786-8977
Practice Address - Street 1:408 NORTH MAIN ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NY
Practice Address - Zip Code:14569
Practice Address - Country:US
Practice Address - Phone:585-786-2219
Practice Address - Fax:585-786-8977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty