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General NPI Number Information
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NPI Number | 1629722426
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Entity Type | Individual
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Provider Name | CLIFFORD PETER DONADIO CADC
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Gender | Male
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Dates
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Enumeration Date | 02/10/2022
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 2040 6TH AVE
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City | NEPTUNE
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State | NJ
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Zip | 07753-6101
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Country | US
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Telephone | 917-453-6312
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Fax |
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Provider Business Mailing Address
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Address Line | 48 NATHAN DR
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City | OLD BRIDGE
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State | NJ
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Zip | 08857-2790
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Country | US
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Telephone | 191-745-3631
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 37CA00154400
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License Number State | NJ
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