Provider Demographics
NPI:1245308303
Name:DONATI, JOHN E (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:DONATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-4802
Mailing Address - Country:US
Mailing Address - Phone:718-256-1057
Mailing Address - Fax:718-256-4912
Practice Address - Street 1:1407 W 6TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-4802
Practice Address - Country:US
Practice Address - Phone:718-256-1057
Practice Address - Fax:718-256-4912
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2383842080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
238384OtherNYS LICENSE
NY02944443Medicaid