Healthcare Provider Details

I. General information

NPI: 1356931000
Provider Name (Legal Business Name): DONNA TRUNZO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2021
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1085 SANDY PLAINS RD
LEEDS NY
12451-1348
US

IV. Provider business mailing address

PO BOX 218
SOUTH CAIRO NY
12482-0218
US

V. Phone/Fax

Practice location:
  • Phone: 518-291-6984
  • Fax:
Mailing address:
  • Phone: 518-291-6984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: