Provider Demographics
NPI:1558547364
Name:PETRUZZI, DONNA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:MARIE
Last Name:PETRUZZI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:DONNA
Other - Middle Name:M
Other - Last Name:CARPENTIERE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:822 ROUTE 82
Mailing Address - Street 2:STE 2
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-7374
Mailing Address - Country:US
Mailing Address - Phone:845-592-2803
Mailing Address - Fax:845-592-1282
Practice Address - Street 1:822 ROUTE 82
Practice Address - Street 2:STE 2
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-7374
Practice Address - Country:US
Practice Address - Phone:845-592-2803
Practice Address - Fax:845-592-1282
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-11
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008065111N00000X
NYX008065-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor