Provider Demographics
NPI:1629722426
Name:DONADIO, CLIFFORD PETER (CADC)
Entity Type:Individual
Prefix:MR
First Name:CLIFFORD
Middle Name:PETER
Last Name:DONADIO
Suffix:
Gender:M
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 NATHAN DR
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-2790
Mailing Address - Country:US
Mailing Address - Phone:191-745-3631
Mailing Address - Fax:
Practice Address - Street 1:2040 6TH AVE
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-6101
Practice Address - Country:US
Practice Address - Phone:917-453-6312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37CA00154400101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)