Provider Demographics
NPI:1922195593
Name:DONAHUE, EILEEN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6930 WILLIAMS RD
Mailing Address - Street 2:SUITE 3700
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-3027
Mailing Address - Country:US
Mailing Address - Phone:716-298-3541
Mailing Address - Fax:716-298-3543
Practice Address - Street 1:6930 WILLIAMS RD
Practice Address - Street 2:SUITE 3700
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-3027
Practice Address - Country:US
Practice Address - Phone:716-298-3541
Practice Address - Fax:716-298-3543
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY330911174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA7485Medicare ID - Type Unspecified