Organization
ANTHONY N. DONATELLI JR MD., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY N DONATELLI JR. MD.,PC (PHYSICIAN)
(631) 730-0406
Entity
Organization
Contact information
Practice address
100 HOSPITAL RD, SUITE 200, EAST PATCHOGUE, NY 11772-8809
(631) 730-0406
Mailing address
PO BOX 406, BROOKHAVEN, NY 11719-0406
(631) 730-0406
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
167827
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
167827
LICENSE
NY
Enumeration date
02/16/2010
Last updated
02/16/2010
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