Nia Alyssa Donawa

Individual provider Active NPI Child Intellectual and/or Developmental Disabilities Respite Care · Deer Park, NY

NPI 1891243093 · NPPES record last updated Sep 15, 2016

Key facts

NPI
1891243093
Entity type
Individual (NPI type 1)
Primary specialty
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X
Practice address
39 Sammis Ave
Deer Park, NY 11729-6717
Phone
(631) 897-0020
NPI assigned
Sep 15, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X Yes

Addresses

Primary practice location

39 Sammis Ave
Deer Park, NY 11729-6717

Mailing address

39 Sammis Ave
Deer Park, NY 11729-6717
Phone (631) 897-0020

Other providers in Deer Park, NY

All providers in Deer Park, NY · Child Intellectual and/or Developmental Disabilities Respite Care in New York

Sources for this page

Verify at the official NPI Registry.