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NPI Code Detail

MEDICARE: ANTOINETTE DONOFRIO

MEDICARE:   ANTOINETTE  DONOFRIO
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
1390200000XStudent in an Organized Health Care Education/Training ProgramNY

General Provider Information

NPI Number : 1649103268
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTOINETTE DONOFRIO
Provider Business Mailing Address
First Line : 546 TENNYSON AVE
Second Line :
City : SYRACUSE
State : NY
Zip : 13204-2521
Country : US
Telephone Number : 412-680-1290
Fax Number :
Provider Business Practice Location Address
First Line : 713 HARRISON ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13210-2305
Country : US
Telephone Number : 315-464-6945
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2026
Last Update Date : 06/04/2026

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Directions to “ ANTOINETTE DONOFRIO ” Practice Location

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