Provider Demographics
NPI:1801282736
Name:DONATELLI, BRIAN ANTHONY (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:ANTHONY
Last Name:DONATELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9 BEATRICE CT
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-5302
Mailing Address - Country:US
Mailing Address - Phone:332-400-6308
Mailing Address - Fax:212-233-2519
Practice Address - Street 1:9 BEATRICE CT
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-5302
Practice Address - Country:US
Practice Address - Phone:332-400-6308
Practice Address - Fax:212-233-2519
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2962442084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry