Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | T0048941 | NY |
NPI | 1013050624 |
---|---|
Provider Name | Dr. Felicia Donnolo |
First Address | Brooklyn, NY 11209-5109 |
Second Address | Brooklyn, NY 11209-5109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T0048941 | OPTOMETRY LICENSE (01) | NY |