Provider Demographics
NPI:1841485083
Name:DONOFRIO, JOSEPH P (RPA-C)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:DONOFRIO
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 WATER ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10041-0004
Mailing Address - Country:US
Mailing Address - Phone:718-491-7169
Mailing Address - Fax:585-463-3105
Practice Address - Street 1:55 WATER ST FL 46
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10041-3211
Practice Address - Country:US
Practice Address - Phone:585-463-3100
Practice Address - Fax:585-463-3105
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011964363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400048880Medicare PIN
NYJ400048882Medicare PIN
NYJ400048879Medicare PIN
NYPA2281Medicare PIN
NYJ400048881Medicare PIN