Provider Demographics
NPI:1497839054
Name:RAZIANO, DONNA BRADY (MD MBA)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:BRADY
Last Name:RAZIANO
Suffix:
Gender:F
Credentials:MD MBA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 299
Mailing Address - Street 2:
Mailing Address - City:MONTCHANIN
Mailing Address - State:DE
Mailing Address - Zip Code:19710-0299
Mailing Address - Country:US
Mailing Address - Phone:215-528-1935
Mailing Address - Fax:610-237-9520
Practice Address - Street 1:1900 S BROAD ST
Practice Address - Street 2:LIFE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-2304
Practice Address - Country:US
Practice Address - Phone:215-339-4747
Practice Address - Fax:215-339-6515
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2021-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD 066 660L207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG87741Medicare UPIN