Provider Demographics
NPI:1336231240
Name:DONOHUE, DEBRA ANN (PT)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:ANN
Last Name:DONOHUE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:DEBRA
Other - Middle Name:ANN
Other - Last Name:SNIFFEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:315 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:SOLVAY
Mailing Address - State:NY
Mailing Address - Zip Code:13209
Mailing Address - Country:US
Mailing Address - Phone:315-484-9447
Mailing Address - Fax:315-484-4583
Practice Address - Street 1:315 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:SOLVAY
Practice Address - State:NY
Practice Address - Zip Code:13209
Practice Address - Country:US
Practice Address - Phone:315-484-9447
Practice Address - Fax:315-484-4583
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0103791225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCC4458Medicare ID - Type Unspecified