Provider Demographics
NPI:1932153723
Name:MADACSI, DONNA G (ARNP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:G
Last Name:MADACSI
Suffix:
Gender:F
Credentials:ARNP
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 848778
Mailing Address - Street 2:GASTROENTEROLOGY GROUP, AMC
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-8778
Mailing Address - Country:US
Mailing Address - Phone:985-871-1721
Mailing Address - Fax:985-893-6908
Practice Address - Street 1:GASTROENTEROLOGY GROUP, AMC
Practice Address - Street 2:131-B CHEROKEE ROSE LANE
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7195
Practice Address - Country:US
Practice Address - Phone:985-871-1721
Practice Address - Fax:985-871-4049
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH055983-23-03363L00000X
LA027133363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1559016Medicaid
LA5T8737384Medicare PIN