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NPI Code Detail

MEDICARE: DR. FELICIA DONNOLO O.D.

MEDICARE: DR. FELICIA DONNOLO O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristT0048941NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1T0048941OTHERNYOPTOMETRY LICENSE

General Provider Information

NPI Number : 1013050624
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FELICIA DONNOLO O.D.
Provider Business Mailing Address
First Line : 8721 4TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-5109
Country : US
Telephone Number : 718-238-3937
Fax Number : 718-238-1091
Provider Business Practice Location Address
First Line : 8721 4TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-5109
Country : US
Telephone Number : 718-238-3937
Fax Number : 718-238-1091
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2007
Last Update Date : 07/08/2007

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