Provider Demographics
NPI:1770976672
Name:DONOHUE, NATASSIA
Entity type:Individual
Prefix:
First Name:NATASSIA
Middle Name:
Last Name:DONOHUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 E MAIN ST
Mailing Address - Street 2:SUITE #1
Mailing Address - City:WASHINGTONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10992-1279
Mailing Address - Country:US
Mailing Address - Phone:845-495-0517
Mailing Address - Fax:
Practice Address - Street 1:87 E MAIN ST
Practice Address - Street 2:SUITE #1
Practice Address - City:WASHINGTONVILLE
Practice Address - State:NY
Practice Address - Zip Code:10992-1279
Practice Address - Country:US
Practice Address - Phone:845-495-0517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator