Provider Demographics
NPI:1093908162
Name:TRAST, DONNA D (RN, BSN, CDE, CPT)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:D
Last Name:TRAST
Suffix:
Gender:F
Credentials:RN, BSN, CDE, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 GINA CT
Mailing Address - Street 2:
Mailing Address - City:HURLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12443-5912
Mailing Address - Country:US
Mailing Address - Phone:845-338-5154
Mailing Address - Fax:
Practice Address - Street 1:124 GINA CT
Practice Address - Street 2:
Practice Address - City:HURLEY
Practice Address - State:NY
Practice Address - Zip Code:12443-5912
Practice Address - Country:US
Practice Address - Phone:845-338-5154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY300766-1163WC3500X, 163WD0400X, 163WN1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support