Healthcare Provider Details

I. General information

NPI: 1740229533
Provider Name (Legal Business Name): DONNA F LAFRATE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DONNA POMFREY

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 08/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3229 E GENESEE ST JOSLIN CENTER
SYRACUSE NY
13214-2016
US

IV. Provider business mailing address

3229 E GENESEE ST JOSLIN CENTER
SYRACUSE NY
13214-2016
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-5726
  • Fax: 315-464-2500
Mailing address:
  • Phone: 315-464-5726
  • Fax: 315-464-2500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number380026
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number380026
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: