MEDICARE: DONN ALBANO LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174N00000X	Lactation Consultant (Non-RN)		MA
2	225700000X	Massage Therapist	18KT01094600	NJ

General Provider Information

NPI Number	:	1205545134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONN ALBANO LMT

Provider Business Mailing Address
First Line	:	PO BOX 20521
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10302-0521
Country	:	US
Telephone Number	:	877-480-8038
Fax Number	:

Provider Business Practice Location Address
First Line	:	1324 FOREST AVE STE 212
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10302-2044
Country	:	US
Telephone Number	:	877-480-8038
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2022
Last Update Date	:	08/15/2023

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Directions to “ DONN ALBANO LMT” Practice Location

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