Provider Demographics
NPI:1124137773
Name:DUVAK, DOLORES A (CRNP)
Entity type:Individual
Prefix:MS
First Name:DOLORES
Middle Name:A
Last Name:DUVAK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 W ELM ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-2007
Mailing Address - Country:US
Mailing Address - Phone:610-567-6964
Mailing Address - Fax:610-567-6170
Practice Address - Street 1:501 S 54TH ST
Practice Address - Street 2:SUITE 196
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-1900
Practice Address - Country:US
Practice Address - Phone:215-748-9707
Practice Address - Fax:215-748-9708
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN222707L163WC2100X
PASP005814163WC2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC2100XNursing Service ProvidersRegistered NurseContinence Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4603990001OtherCIGNA
PA1567867OtherBLUE SHIELD