Provider Demographics
NPI:1417045618
Name:VOGT, DONNA M (CNP)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:M
Last Name:VOGT
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MS
Other - First Name:DONNA
Other - Middle Name:M
Other - Last Name:VOGT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNP
Mailing Address - Street 1:4154 MCKINLEY PKWY
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:BLASDELL
Mailing Address - State:NY
Mailing Address - Zip Code:14219-2995
Mailing Address - Country:US
Mailing Address - Phone:716-649-6500
Mailing Address - Fax:716-649-0031
Practice Address - Street 1:4154 MCKINLEY PKWY
Practice Address - Street 2:SUITE 1200
Practice Address - City:BLASDELL
Practice Address - State:NY
Practice Address - Zip Code:14219-2995
Practice Address - Country:US
Practice Address - Phone:716-649-6500
Practice Address - Fax:716-649-0031
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420241-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY95118691OtherINDEPENDENT HEALTH
NY560026005OtherUNIVERA
NY161019149OtherAETNA
NYRB1975OtherMEDICARE UPIN
NY01903300Medicaid
NY161019149OtherUNITED HEALTH CARE
NY161019149OtherEMPIRE