Provider Demographics
NPI:1982786828
Name:GOEBEL, DONNA M (DC)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:M
Last Name:GOEBEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 JOSIAH PATH
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540
Mailing Address - Country:US
Mailing Address - Phone:516-526-7967
Mailing Address - Fax:
Practice Address - Street 1:6 JOSIAH PATH
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540
Practice Address - Country:US
Practice Address - Phone:516-526-7967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0046511111N00000X
NYX004651111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T71249Medicare UPIN
NYT71249Medicare UPIN
NYX30731Medicare ID - Type Unspecified