Provider Demographics
NPI:1609854306
Name:ARNOLD, DONNA A (PA)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:A
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SANTEE DR
Mailing Address - Street 2:
Mailing Address - City:GANSEVOORT
Mailing Address - State:NY
Mailing Address - Zip Code:12831-1322
Mailing Address - Country:US
Mailing Address - Phone:518-581-9989
Mailing Address - Fax:
Practice Address - Street 1:108 N BALLSTON AVE
Practice Address - Street 2:
Practice Address - City:SCOTIA
Practice Address - State:NY
Practice Address - Zip Code:12302-2520
Practice Address - Country:US
Practice Address - Phone:518-393-8898
Practice Address - Fax:518-393-8606
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003589363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant