Provider Demographics
NPI:1457474710
Name:CAMPIONE, DONNA (SOCIAL WORKER)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:
Last Name:CAMPIONE
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DONNA CAMPIONE, L40 FIFTH AVE.
Mailing Address - Street 2:10B
Mailing Address - City:NEW YORK,
Mailing Address - State:NY
Mailing Address - Zip Code:10011
Mailing Address - Country:US
Mailing Address - Phone:212-255-7746
Mailing Address - Fax:212-460-8644
Practice Address - Street 1:41-51 EAST LLTH STREET.
Practice Address - Street 2:4TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NE
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-255-7746
Practice Address - Fax:212-460-8644
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR048615-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEN25C41Medicare ID - Type Unspecified