Provider Demographics
NPI:1558481002
Name:DEGIOVINE, DONNA MARIA (APN)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:MARIA
Last Name:DEGIOVINE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CARLSTADT
Mailing Address - State:NJ
Mailing Address - Zip Code:07072-1005
Mailing Address - Country:US
Mailing Address - Phone:201-939-1114
Mailing Address - Fax:
Practice Address - Street 1:122-132 CLINTON ST
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-8519
Practice Address - Country:US
Practice Address - Phone:201-418-3159
Practice Address - Fax:201-418-3151
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN10017100363LA2200X
NYF302595-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health