Provider Demographics
NPI:1083909691
Name:COLASANTI, DEANNA ELIZABETH (RN)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:ELIZABETH
Last Name:COLASANTI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 DAVID LN
Mailing Address - Street 2:
Mailing Address - City:LAKE RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-4302
Mailing Address - Country:US
Mailing Address - Phone:631-648-8458
Mailing Address - Fax:
Practice Address - Street 1:5 DAVID LN
Practice Address - Street 2:
Practice Address - City:LAKE RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-4302
Practice Address - Country:US
Practice Address - Phone:631-648-8458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY562605-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse