Provider Demographics
NPI:1144204421
Name:CROCE, DONNA J (PT OCS)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:J
Last Name:CROCE
Suffix:
Gender:F
Credentials:PT OCS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:98 CUTTERMILL RD
Mailing Address - Street 2:#100
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3006
Mailing Address - Country:US
Mailing Address - Phone:516-466-4118
Mailing Address - Fax:516-466-2856
Practice Address - Street 1:98 CUTTERMILL RD
Practice Address - Street 2:#100
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-3006
Practice Address - Country:US
Practice Address - Phone:516-466-4118
Practice Address - Fax:516-466-2856
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0084451225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q66251Medicare ID - Type Unspecified