Provider Demographics
NPI:1942861299
Name:ALCANTARA, DONNAH IGNACIA DIMA-ALA
Entity Type:Individual
Prefix:
First Name:DONNAH IGNACIA
Middle Name:DIMA-ALA
Last Name:ALCANTARA
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 1:1325 5TH AVE APT 6J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-2645
Mailing Address - Country:US
Mailing Address - Phone:212-426-9462
Mailing Address - Fax:
Practice Address - Street 1:1325 5TH AVE APT 6J
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-2645
Practice Address - Country:US
Practice Address - Phone:212-426-9462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst