Provider Demographics
NPI:1821281502
Name:NEVIN, DONNA G (PT)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:G
Last Name:NEVIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 GRANADA CRES APT 22
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-1242
Mailing Address - Country:US
Mailing Address - Phone:914-946-5409
Mailing Address - Fax:914-946-5409
Practice Address - Street 1:14 GRANADA CRES APT 22
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-1242
Practice Address - Country:US
Practice Address - Phone:914-946-5409
Practice Address - Fax:914-946-5409
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPT1892225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist