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Individual

DONNA B SERGIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1508 GENESEE ST, UTICA, NY 13502
(315) 798-8737
Mailing address
1406 FRANKLYN ST, ROME, NY 13440-2815

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
400783
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F302788-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03346036
NY
05
400783
NY
Enumeration date
06/05/2007
Last updated
07/02/2018
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