Individual
SARA R DONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
3959 BROADWAY, CHN 2, NEW YORK, NY 10032-1559
(212) 342-8585
Mailing address
PO BOX 27036, NEW YORK, NY 10087-7036
(212) 342-8585
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F382054-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01265989
—
NY
Enumeration date
03/09/2009
Last updated
08/15/2013
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