Provider Demographics
NPI:1790836682
Name:ZAKEN, DONNA (NP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:ZAKEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CASCADE RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-3865
Mailing Address - Country:US
Mailing Address - Phone:845-986-6378
Mailing Address - Fax:845-986-6380
Practice Address - Street 1:100 CASCADE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-3865
Practice Address - Country:US
Practice Address - Phone:845-986-6378
Practice Address - Fax:845-986-6380
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY304134363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health