Provider Demographics
NPI:1275808842
Name:CAGGIANO, DONNA JOANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:JOANN
Last Name:CAGGIANO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 MERRILL AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3311
Mailing Address - Country:US
Mailing Address - Phone:718-761-3325
Mailing Address - Fax:
Practice Address - Street 1:55 MERRILL AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3311
Practice Address - Country:US
Practice Address - Phone:718-761-3325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY480607-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse