Provider Demographics
NPI:1093943623
Name:DONAUBAUER, SALLY DAWN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:DAWN
Last Name:DONAUBAUER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 W 56TH ST
Mailing Address - Street 2:SUITE 6M
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3866
Mailing Address - Country:US
Mailing Address - Phone:212-246-3700
Mailing Address - Fax:212-246-3701
Practice Address - Street 1:130 W 56TH ST
Practice Address - Street 2:SUITE 6M
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3866
Practice Address - Country:US
Practice Address - Phone:212-246-3700
Practice Address - Fax:212-246-3701
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030500-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist