Provider Demographics
NPI:1295075901
Name:VAHOVIUS, DONNA KATHLEEN I (PMHNP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:KATHLEEN
Last Name:VAHOVIUS
Suffix:I
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 HEMPSTEAD TPKE RM 203
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-1152
Mailing Address - Country:US
Mailing Address - Phone:516-559-4041
Mailing Address - Fax:
Practice Address - Street 1:510 HEMPSTEAD TPKE RM 203
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-1152
Practice Address - Country:US
Practice Address - Phone:516-559-4041
Practice Address - Fax:949-419-3482
Is Sole Proprietor?:No
Enumeration Date:2013-02-18
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1074084363LP0808X
FLAPRN11019734363LP0808X
AL1-095501363LF0000X
NYF404263-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF404263-01OtherLICENSE
TX1074084OtherLICENSE
FLAPRN11019734OtherLICENSE