Provider Demographics
NPI:1689877805
Name:HALLAS, DONNA MARIE (DILLANE) (PHD, APRN, BC, CPNP)
Entity Type:Individual
Prefix:PROF
First Name:DONNA
Middle Name:MARIE (DILLANE)
Last Name:HALLAS
Suffix:
Gender:F
Credentials:PHD, APRN, BC, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CARPENTER LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-5208
Mailing Address - Country:US
Mailing Address - Phone:718-526-7533
Mailing Address - Fax:718-262-0643
Practice Address - Street 1:8930 161ST ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-6105
Practice Address - Country:US
Practice Address - Phone:718-526-7533
Practice Address - Fax:718-262-0643
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF380421-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF380421-1OtherPNP CERTIFICATE