Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 1514821 | NY |
NPI | 1053415133 |
---|---|
Provider Name | Dr. Robert Bruce Donadt |
First Address | Melville, NY 11747-4230 |
Second Address | Forest Hills, NY 11375-3846 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2006 |
Last Update Date | 17/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01151266 | (05) | NY |
A60862 | (02) |