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Individual

DR. DONNA A ANNILLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.P.M.

Contact information

Practice address
933 GARRISON AVE, TEANECK, NJ 07666-2653
(201) 836-0003
(201) 836-0003
Mailing address
933 GARRISON AVENUE, TEANECK, NJ 07666-2653
(201) 836-0003
(201) 836-0003

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
25MD00171900
NJ
213ES0000X
Sports Medicine Podiatrist
25MD00171900
NJ
213ES0103X
Foot & Ankle Surgery Podiatrist
25MD00171900
NJ
213ES0131X
Foot Surgery Podiatrist
25MD00171900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4826507
NJ
Enumeration date
06/15/2006
Last updated
05/03/2012
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