Provider Demographics
NPI:1588041297
Name:DONNA PRINCIPIO
Entity Type:Organization
Organization Name:DONNA PRINCIPIO
Other - Org Name:PRINCESS CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MISS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PRINCIPIO
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:315-651-3390
Mailing Address - Street 1:2535 BREWER RD
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:NY
Mailing Address - Zip Code:13165-9592
Mailing Address - Country:US
Mailing Address - Phone:315-651-3390
Mailing Address - Fax:
Practice Address - Street 1:2535 BREWER RD
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:NY
Practice Address - Zip Code:13165-9592
Practice Address - Country:US
Practice Address - Phone:315-651-3390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-01
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY321372-1311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home