MEDICARE: MISS DONNA MARIE DONATO OTR/L

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	174400000X	Specialist	63-011782	NY

General Provider Information

NPI Number	:	1770736209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS DONNA MARIE DONATO OTR/L

Provider Business Mailing Address
First Line	:	224 1ST AVE APT 5C
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10009-3456
Country	:	US
Telephone Number	:	212-982-2456
Fax Number	:

Provider Business Practice Location Address
First Line	:	224 1ST AVE APT 5C
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10009-3456
Country	:	US
Telephone Number	:	212-982-2456
Fax Number	:

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

Provider Enumeration Date	:	10/28/2008
Last Update Date	:	10/28/2008

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