Provider Demographics
NPI:1598822348
Name:ANNICELLI, DONNA ELLEN (MS, CCC-A)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:ELLEN
Last Name:ANNICELLI
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-2605
Mailing Address - Country:US
Mailing Address - Phone:401-884-0496
Mailing Address - Fax:401-884-0496
Practice Address - Street 1:200 TOLL GATE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4440
Practice Address - Country:US
Practice Address - Phone:401-737-1760
Practice Address - Fax:401-737-1740
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAUD00166237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI2414887OtherUNITED HEALTHCARE