Individual
MRS. DONNA LYNN BLANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26 NORMA BLVD, HOLBROOK, NY 11741-1717
(631) 676-4931
Mailing address
10 VILLAGE ST, HOLBROOK, NY 11741-1731
(631) 285-6532
Taxonomy
Speciality
Code
Description
License number
State
374T00000X
Religious Nonmedical Nursing Personnel
Primary
22474562
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02206724
—
NY
Enumeration date
07/20/2007
Last updated
07/20/2007
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