Provider Demographics
NPI:1063604296
Name:CINCO, DONABEL
Entity type:Individual
Prefix:
First Name:DONABEL
Middle Name:
Last Name:CINCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:458 LINCOLN AVE
Mailing Address - Street 2:A1
Mailing Address - City:ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07050-2284
Mailing Address - Country:US
Mailing Address - Phone:973-673-5610
Mailing Address - Fax:
Practice Address - Street 1:458 LINCOLN AVE
Practice Address - Street 2:A1
Practice Address - City:ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07050-2284
Practice Address - Country:US
Practice Address - Phone:973-673-5610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-12
Last Update Date:2007-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA11165000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist