Provider Demographics
NPI:1134373541
Name:HYACINTH, DONNA MARIE (OTR)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:MARIE
Last Name:HYACINTH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1366 E 40TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-2918
Mailing Address - Country:US
Mailing Address - Phone:718-377-4619
Mailing Address - Fax:718-377-4619
Practice Address - Street 1:1366 E 40TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-2918
Practice Address - Country:US
Practice Address - Phone:718-377-4619
Practice Address - Fax:718-377-4619
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0699510252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency