Provider Demographics
NPI:1023200243
Name:DONNA SOLES
Entity Type:Organization
Organization Name:DONNA SOLES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SOLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-621-7087
Mailing Address - Street 1:88 FAWN HILL RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-3954
Mailing Address - Country:US
Mailing Address - Phone:585-621-7087
Mailing Address - Fax:
Practice Address - Street 1:600 ISLAND COTTAGE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-2300
Practice Address - Country:US
Practice Address - Phone:585-621-2446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-11
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02572094Medicaid