Provider Demographics
NPI:1336220409
Name:COTY, DONNA DEANNE (DC)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:DEANNE
Last Name:COTY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6050 US ROUTE 11
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:NY
Mailing Address - Zip Code:13084
Mailing Address - Country:US
Mailing Address - Phone:315-677-0107
Mailing Address - Fax:315-849-9639
Practice Address - Street 1:2471 US 11
Practice Address - Street 2:LAFAYETTE CHIROPRACTIC CENTER
Practice Address - City:LAFAYETTE
Practice Address - State:NY
Practice Address - Zip Code:13084
Practice Address - Country:US
Practice Address - Phone:315-677-0107
Practice Address - Fax:315-677-0107
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007915111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56451BMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER