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NPI Code Detail

MEDICARE: DR. DONNA M CHIMERA PH.D.

MEDICARE: DR. DONNA M CHIMERA PH.D.
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
1103TC0700XClinical Psychologist9297NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10013512OTHERNYVALUE OPTIONS - GHI

General Provider Information

NPI Number : 1285653691
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONNA M CHIMERA PH.D.
Provider Business Mailing Address
First Line : 3 SPRUCE CT
Second Line :
City : NORTH BALDWIN
State : NY
Zip : 11510-2745
Country : US
Telephone Number : 516-377-3345
Fax Number :
Provider Business Practice Location Address
First Line : 3 SPRUCE CT
Second Line :
City : NORTH BALDWIN
State : NY
Zip : 11510-2745
Country : US
Telephone Number : 516-377-3345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 02/11/2008

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