Provider Demographics
NPI:1205545134
Name:ALBANO, DONN (LMT)
Entity type:Individual
Prefix:
First Name:DONN
Middle Name:
Last Name:ALBANO
Suffix:
Gender:M
Credentials:LMT
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 20521
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10302-0521
Mailing Address - Country:US
Mailing Address - Phone:877-480-8038
Mailing Address - Fax:
Practice Address - Street 1:1324 FOREST AVE STE 212
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10302-2044
Practice Address - Country:US
Practice Address - Phone:877-480-8038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-18
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA174N00000X
NJ18KT01094600225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No174N00000XOther Service ProvidersLactation Consultant, Non-RN