Healthcare Provider Details

I. General information

NPI: 1053093799
Provider Name (Legal Business Name): PATRICK JOSEPH DONAHOE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2023
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2047 PA-309
ALLENTOWN PA
18104
US

IV. Provider business mailing address

589 E LAWN RD
NAZARETH PA
18064-1211
US

V. Phone/Fax

Practice location:
  • Phone: 484-276-4646
  • Fax:
Mailing address:
  • Phone: 484-215-2640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW026467
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: