Individual
JOHN DONOFRIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
792 HARRISON AVE, RIVERHEAD, NY 11901-2744
(631) 591-3120
Mailing address
792 HARRISON AVE, RIVERHEAD, NY 11901-2744
(631) 591-3120
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
306118
NY
Other
Enumeration date
07/15/2012
Last updated
07/15/2012
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