Provider Demographics
NPI:1225379530
Name:MAGGIO, DONNA LYNN (COTA)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LYNN
Last Name:MAGGIO
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WIERK AVE
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:NY
Mailing Address - Zip Code:12754-2117
Mailing Address - Country:US
Mailing Address - Phone:845-295-4000
Mailing Address - Fax:845-292-8694
Practice Address - Street 1:29 SCHOOLHOUSE RD
Practice Address - Street 2:
Practice Address - City:WHITE SULPHUR SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12787
Practice Address - Country:US
Practice Address - Phone:845-295-4000
Practice Address - Fax:845-292-8694
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008194-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics