Provider Demographics
NPI:1104294735
Name:NIELD, DONNA (L AC)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:NIELD
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E 4TH ST APT 24
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-7226
Mailing Address - Country:US
Mailing Address - Phone:646-853-2644
Mailing Address - Fax:
Practice Address - Street 1:225 E 4TH ST APT 24
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-7226
Practice Address - Country:US
Practice Address - Phone:646-853-2644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005635-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist