Active NPI
Mark Donnelly, L.AC., MS
- Acupuncturist
- Farmingdale, NY
National Provider Identifier
1902133978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 001633-1
- Practice address
- 177 Conklin St
Farmingdale, NY 11735-2501 - Phone
- (516) 249-3236
- Fax
- (516) 249-8514
- NPI assigned
- Nov 11, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 001633-1 | NY | Primary |
Addresses
Primary practice location
177 Conklin St
Farmingdale, NY 11735-2501
Mailing address
13 Circle LN
Levittown, NY 11756-2703
Phone (516) 735-1699
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001633-1 | NY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257897600000",
"number": "1902133978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 CIRCLE LN",
"city": "LEVITTOWN",
"state": "NY",
"postal_code": "117562703",
"telephone_number": "516-735-1699",
"fax_number": "516-249-8514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "177 CONKLIN ST",
"city": "FARMINGDALE",
"state": "NY",
"postal_code": "117352501",
"telephone_number": "516-249-3236",
"fax_number": "516-249-8514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONNELLY",
"first_name": "MARK",
"name_prefix": "Mr.",
"credential": "L.AC., MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-11-11",
"last_updated": "2009-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "001633-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmingdale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.