Provider Demographics
NPI:1194837526
Name:DONNERY, GAIL MCCUE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:MCCUE
Last Name:DONNERY
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E GENESEE ST STE 403
Mailing Address - Street 2:HILL MEDICAL CENTER
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1840
Mailing Address - Country:US
Mailing Address - Phone:315-464-2929
Mailing Address - Fax:315-464-2930
Practice Address - Street 1:1000 E GENESEE ST STE 403
Practice Address - Street 2:HILL MEDICAL CENTER
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1840
Practice Address - Country:US
Practice Address - Phone:315-464-2929
Practice Address - Fax:315-464-2930
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301616363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03418522Medicaid
NY03418522Medicaid
NYJ400064991Medicare PIN