Provider Demographics
NPI:1770163263
Name:DONALDSON, NATHANIEL II
Entity type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:
Last Name:DONALDSON
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CITY HALL PLZ UNIT 207
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-5193
Mailing Address - Country:US
Mailing Address - Phone:732-427-0549
Mailing Address - Fax:
Practice Address - Street 1:4 CITY HALL PLZ UNIT 207
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-5193
Practice Address - Country:US
Practice Address - Phone:732-427-0549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-09
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010884225200000X
NJ40QB00392800225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant