Provider Demographics
NPI:1396079133
Name:HAVIR, DONA M (RN)
Entity type:Individual
Prefix:
First Name:DONA
Middle Name:M
Last Name:HAVIR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ULSTER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12487-5110
Mailing Address - Country:US
Mailing Address - Phone:845-339-2929
Mailing Address - Fax:
Practice Address - Street 1:617 BROADWAY
Practice Address - Street 2:
Practice Address - City:ULSTER PARK
Practice Address - State:NY
Practice Address - Zip Code:12487-5110
Practice Address - Country:US
Practice Address - Phone:845-339-2929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-27
Last Update Date:2009-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY591932163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse