Basic Information
| Provider Information | |||||||||
| NPI: | 1619195070 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOLENA | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | FRANCIS | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 283 S. BUTLER RD. | ||||||||
| Address2: | PHILHAVEN BEHAVIORAL HEALTH SERVICES | ||||||||
| City: | MT GRETNA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172738871 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 283 S. BUTLER RD. | ||||||||
| Address2: | PHILHAVEN BEHAVIORAL HEALTH SERVICES | ||||||||
| City: | MT GRETNA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172738871 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2007 | ||||||||
| LastUpdateDate: | 07/29/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | OS014663 | PA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.