Healthcare Provider Details

I. General information

NPI: 1891878807
Provider Name (Legal Business Name): LUCIA S DONATELLI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S MARLYN AVE
BALTIMORE MD
21221-5939
US

IV. Provider business mailing address

5333 ABBEYWOOD CT
BALTIMORE MD
21237-4932
US

V. Phone/Fax

Practice location:
  • Phone: 410-238-0238
  • Fax:
Mailing address:
  • Phone: 410-931-0222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0057396
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License NumberD0057396
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: