Provider Demographics
NPI:1245292077
Name:CATELL, DONNA T (MD)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:T
Last Name:CATELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 1ST ST
Mailing Address - Street 2:ATTN: DEPT OF RADIOLOGY
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3957
Mailing Address - Country:US
Mailing Address - Phone:516-663-2501
Mailing Address - Fax:516-663-8558
Practice Address - Street 1:259 1ST ST
Practice Address - Street 2:ATTN: DEPT OF RADIOLOGY
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3957
Practice Address - Country:US
Practice Address - Phone:516-663-2501
Practice Address - Fax:516-663-8558
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2047182085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03079265Medicaid
H24791Medicare UPIN
A400025344Medicare PIN