Provider Demographics
NPI:1427313584
Name:ROSSI-HAVERN, DONNA M (MS SPED)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:ROSSI-HAVERN
Suffix:
Gender:F
Credentials:MS SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 W. PARKVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:SHIRLEY
Mailing Address - State:NY
Mailing Address - Zip Code:11967-4319
Mailing Address - Country:US
Mailing Address - Phone:631-379-0827
Mailing Address - Fax:
Practice Address - Street 1:71 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-4319
Practice Address - Country:US
Practice Address - Phone:631-379-0827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist