Provider Demographics
NPI:1962448787
Name:FOX, DONNA O (RD , CDE)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:O
Last Name:FOX
Suffix:
Gender:F
Credentials:RD , CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2000
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-2000
Mailing Address - Country:US
Mailing Address - Phone:518-828-8363
Mailing Address - Fax:518-697-3388
Practice Address - Street 1:1301 RIVER ST
Practice Address - Street 2:SUITE 204
Practice Address - City:VALATIE
Practice Address - State:NY
Practice Address - Zip Code:12184-9694
Practice Address - Country:US
Practice Address - Phone:518-758-2792
Practice Address - Fax:518-758-1439
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001062133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
P68680Medicare UPIN
NY9032E1Medicare PIN