Provider Demographics
NPI:1164794814
Name:DELLAROCCO-SWAINE, DONA
Entity Type:Individual
Prefix:
First Name:DONA
Middle Name:
Last Name:DELLAROCCO-SWAINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-1454
Mailing Address - Country:US
Mailing Address - Phone:631-476-4743
Mailing Address - Fax:
Practice Address - Street 1:27 WALNUT ST
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-1454
Practice Address - Country:US
Practice Address - Phone:631-476-4743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY479617163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse