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General NPI Number Information
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NPI Number | 1992063820
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Entity Type | Organization
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Legal Business Name | GLORIA B. DONAII
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Dates
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Enumeration Date | 04/29/2012
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Last Update Date | 04/29/2012
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Provider Practice Location Address
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Address Line | 60 SEYMOUR LN
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City | MEDFORD
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State | NY
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Zip | 11763-1061
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Country | US
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Telephone | 631-576-7050
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Fax |
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Provider Business Mailing Address
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Address Line | 60 SEYMOUR LN
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City | MEDFORD
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State | NY
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Zip | 11763-1061
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Country | US
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Telephone | 631-576-7050
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | GLORIA B DONAII
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Credential |
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Telephone | 631-576-7052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 267481-1
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License Number State | NY
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