Provider Demographics
NPI:1194807354
Name:TABAS, DONNA (CNM)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:TABAS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 JODI LN
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-2855
Mailing Address - Country:US
Mailing Address - Phone:914-980-0624
Mailing Address - Fax:845-639-3159
Practice Address - Street 1:3196 KENNEDY BLVD
Practice Address - Street 2:BOX 10
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-2436
Practice Address - Country:US
Practice Address - Phone:845-639-3098
Practice Address - Fax:845-639-3159
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00041401176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife