Healthcare Provider Details

I. General information

NPI: 1497800858
Provider Name (Legal Business Name): DEBORAH KIM DOOLEY MSEDCCCSLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. DEBORAH KIM DONNARUMA

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 FREYA RD
ROCKY POINT NY
11778
US

IV. Provider business mailing address

102 FREYA RD
ROCKY POINT NY
11778
US

V. Phone/Fax

Practice location:
  • Phone: 631-278-4674
  • Fax:
Mailing address:
  • Phone: 631-278-4674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number008704
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number008704-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: