Individual
DR. DONNA J.C. FANELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
120 PARK AVE, LOWER LEVEL C, NEW YORK, NY 10017-5577
(646) 324-9461
(646) 324-1020
Mailing address
ADVANTAGECARE PHYSICIANS, PC, 55 WATER STREET 2ND FLOOR CRED DEPT, NEW YORK, NY 10041-0004
(646) 680-2888
(516) 542-5556
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
26NN06605500
NJ
363LA2100X
Acute Care Nurse Practitioner
F430118-1
NY
363LA2200X
Adult Health Nurse Practitioner
26NN06605500
NJ
363LA2200X
Adult Health Nurse Practitioner
Primary
F303208-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0067199
—
NJ
01
—
123
CIGNA
NJ
01
—
2517320
UNITED HEALTHCARE
NJ
01
—
286989
AMERIGROUP
NJ
01
—
2K9125
HEALTH NET
NJ
01
—
3598174
OXFORD
NJ
Enumeration date
11/08/2005
Last updated
12/02/2019
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