Provider Demographics
NPI:1891243093
Name:DONAWA, NIA ALYSSA
Entity Type:Individual
Prefix:MS
First Name:NIA
Middle Name:ALYSSA
Last Name:DONAWA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 SAMMIS AVE
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-6717
Mailing Address - Country:US
Mailing Address - Phone:631-897-0020
Mailing Address - Fax:
Practice Address - Street 1:39 SAMMIS AVE
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-6717
Practice Address - Country:US
Practice Address - Phone:631-897-0020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child