Provider Demographics
NPI:1639126758
Name:DONOHUE, DANE PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:DANE
Middle Name:PATRICK
Last Name:DONOHUE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 FRIENDS LANE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940
Mailing Address - Country:US
Mailing Address - Phone:215-968-1661
Mailing Address - Fax:215-968-1661
Practice Address - Street 1:121 FRIENDS LANE
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940
Practice Address - Country:US
Practice Address - Phone:215-968-1661
Practice Address - Fax:215-968-1661
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004895L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP1110083OtherOXFORD
PA012572900OtherIBC
PA386302OtherHIGHMARK
U35716Medicare UPIN
PAD0112038Medicare ID - Type Unspecified