Healthcare Provider Details

I. General information

NPI: 1295810596
Provider Name (Legal Business Name): DONI MASSEY PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DONI PITCHFORD PA

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 DELAWARE DR STE 205
NEW HYDE PARK NY
11042-1116
US

IV. Provider business mailing address

14616 LINDEN BLVD
JAMAICA NY
11436-1124
US

V. Phone/Fax

Practice location:
  • Phone: 516-622-6088
  • Fax: 516-622-6082
Mailing address:
  • Phone: 718-920-2966
  • Fax: 718-653-1587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number005906
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: