Provider Demographics
NPI:1295810596
Name:MASSEY, DONI (PA)
Entity type:Individual
Prefix:
First Name:DONI
Middle Name:
Last Name:MASSEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:DONI
Other - Middle Name:
Other - Last Name:PITCHFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:14616 LINDEN BLVD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11436-1124
Mailing Address - Country:US
Mailing Address - Phone:718-920-2966
Mailing Address - Fax:718-653-1587
Practice Address - Street 1:3 DELAWARE DR STE 205
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1116
Practice Address - Country:US
Practice Address - Phone:516-622-6088
Practice Address - Fax:516-622-6082
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005906363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant