Provider Demographics
NPI:1962752741
Name:GOODING, DONNA DIANA (ASSOCIATE / NURSING-)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:DIANA
Last Name:GOODING
Suffix:
Gender:F
Credentials:ASSOCIATE / NURSING-
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W. COLUMBIA ST.
Mailing Address - Street 2:APT 7H
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550
Mailing Address - Country:US
Mailing Address - Phone:516-410-2193
Mailing Address - Fax:
Practice Address - Street 1:150 W. COLUMBIA ST.
Practice Address - Street 2:APT 7H
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550
Practice Address - Country:US
Practice Address - Phone:516-410-2193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY522851-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse