Provider Demographics
NPI:1255660015
Name:PERAGINE, DONNA
Entity Type:Individual
Prefix:MISS
First Name:DONNA
Middle Name:
Last Name:PERAGINE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:PERAGINE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:3184A RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-1900
Mailing Address - Country:US
Mailing Address - Phone:718-351-9212
Mailing Address - Fax:718-351-9212
Practice Address - Street 1:3184A RICHMOND RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-1900
Practice Address - Country:US
Practice Address - Phone:917-327-3716
Practice Address - Fax:718-351-9212
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334410363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily