Provider Demographics
NPI:1407165889
Name:TUZZA, DONNA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:
Last Name:TUZZA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CONNETQUOT AVE
Mailing Address - Street 2:APARTMENT 22
Mailing Address - City:EAST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11730-1464
Mailing Address - Country:US
Mailing Address - Phone:631-650-0299
Mailing Address - Fax:
Practice Address - Street 1:115 CONNETQUOT AVE
Practice Address - Street 2:APARTMENT 22
Practice Address - City:EAST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11730-1464
Practice Address - Country:US
Practice Address - Phone:631-650-0299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010767-1171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor