Provider Demographics
NPI:1649309709
Name:COLE, DONNA M (OT)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:M
Last Name:COLE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 POST AVE
Mailing Address - Street 2:SUITE100
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-2265
Mailing Address - Country:US
Mailing Address - Phone:516-333-3253
Mailing Address - Fax:516-333-8452
Practice Address - Street 1:355 POST AVE
Practice Address - Street 2:SUITE100
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-2265
Practice Address - Country:US
Practice Address - Phone:516-333-3253
Practice Address - Fax:516-333-8452
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY010072-1OtherOT LICENSE