Provider Demographics
NPI:1780733899
Name:CECE, DONNA LOUISE (PA)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:LOUISE
Last Name:CECE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 SHORE RD APT 2D
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-5303
Mailing Address - Country:US
Mailing Address - Phone:516-658-3851
Mailing Address - Fax:
Practice Address - Street 1:515 MADISON AVE RM 1720
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5444
Practice Address - Country:US
Practice Address - Phone:212-758-3939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010891363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical