Provider Demographics
NPI:1710413786
Name:MENDONCA, DONNA (DNP)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:MENDONCA
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 CLARKSON AVE # MSC50
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2012
Mailing Address - Country:US
Mailing Address - Phone:718-221-6195
Mailing Address - Fax:718-270-1559
Practice Address - Street 1:470 CLARKSON AVE # MSC50
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2012
Practice Address - Country:US
Practice Address - Phone:718-221-6195
Practice Address - Fax:718-270-1559
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF341223-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily