Provider Demographics
NPI:1508931098
Name:DONNELLY, ANASTASIA M (ANPC)
Entity Type:Individual
Prefix:MRS
First Name:ANASTASIA
Middle Name:M
Last Name:DONNELLY
Suffix:
Gender:F
Credentials:ANPC
Other - Prefix:
Other - First Name:ANASTASIA
Other - Middle Name:M
Other - Last Name:DOWLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2131 RT 33
Mailing Address - Street 2:LEXINGTON SQUARE COMMONS
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690
Mailing Address - Country:US
Mailing Address - Phone:609-585-4900
Mailing Address - Fax:609-585-4902
Practice Address - Street 1:2131 HIGHWAY 33
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690
Practice Address - Country:US
Practice Address - Phone:609-585-4900
Practice Address - Fax:609-585-5490
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00079400363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
V089552RYDMedicare ID - Type Unspecified
Q40129Medicare UPIN