MEDICARE: JANE DONAGHY

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
1	224Z00000X	Occupational Therapy Assistant	073.0000147	VT
2	224Z00000X	Occupational Therapy Assistant	1999	MA

General Provider Information

NPI Number	:	1578912440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE DONAGHY

Provider Business Mailing Address
First Line	:	81 MEDICAL VILLAGE DR
Second Line	:
City	:	NEWPORT
State	:	VT
Zip	:	05855-9897
Country	:	US
Telephone Number	:	802-334-3260
Fax Number	:

Provider Business Practice Location Address
First Line	:	81 MEDICAL VILLAGE DR
Second Line	:
City	:	NEWPORT
State	:	VT
Zip	:	05855-9897
Country	:	US
Telephone Number	:	802-334-3260
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2016
Last Update Date	:	06/10/2016

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Directions to “ JANE DONAGHY ” Practice Location

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