Provider Demographics
NPI:1063705358
Name:ACCETTULLI, DONNA MARIE (CRISIS PARA)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:MARIE
Last Name:ACCETTULLI
Suffix:
Gender:F
Credentials:CRISIS PARA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 E 94TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0779
Mailing Address - Country:US
Mailing Address - Phone:212-860-1400
Mailing Address - Fax:212-722-6693
Practice Address - Street 1:71 E 94TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-0779
Practice Address - Country:US
Practice Address - Phone:212-860-1400
Practice Address - Fax:212-722-6693
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY20114709717OtherCRISIS PARAPROFESSIONAL