Provider Demographics
NPI:1144426867
Name:DONAHUE, RICHARD JAMES III (IDC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:JAMES
Last Name:DONAHUE
Suffix:III
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613B BLANDY RD
Mailing Address - Street 2:NWS EARLE
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722
Mailing Address - Country:US
Mailing Address - Phone:732-323-7106
Mailing Address - Fax:
Practice Address - Street 1:BLDG. 39 LANSDOWNE ROAD BRANCH HEALTH CLINIC
Practice Address - Street 2:NAVAL AIR ENGINEERING STATION
Practice Address - City:LAKEHURST
Practice Address - State:NJ
Practice Address - Zip Code:08733
Practice Address - Country:US
Practice Address - Phone:732-323-7106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other