Provider Demographics
NPI:1932379559
Name:MCDONALD, DEANNA MARISA (MD)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:MARISA
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 E ROBINSON RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WEST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2041
Mailing Address - Country:US
Mailing Address - Phone:716-691-3400
Mailing Address - Fax:716-691-3404
Practice Address - Street 1:3950 E ROBINSON RD
Practice Address - Street 2:SUITE 204
Practice Address - City:WEST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2041
Practice Address - Country:US
Practice Address - Phone:716-691-3400
Practice Address - Fax:716-691-3404
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY244979173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine