Provider Demographics
NPI:1003170044
Name:CONK, DONNA M (EDD)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:M
Last Name:CONK
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 PRESTON ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2054
Mailing Address - Country:US
Mailing Address - Phone:516-971-1767
Mailing Address - Fax:
Practice Address - Street 1:71 PRESTON ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2054
Practice Address - Country:US
Practice Address - Phone:516-971-1767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist